Gogo Otokwala Job, Romokere Akpa Maclean, Oluchi Stanley Rosemary
Intensive Care Unit, Department of Anaesthesia, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Cardiology Unit, Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Niger Med J. 2025 Apr 3;66(1):337-346. doi: 10.71480/nmj.v66i1.742. eCollection 2025 Jan-Feb.
Intensive care units offer specialized care to critically ill patients and are an integral part of modern health care. In low-income countries, with limited resources, the demand to optimize patient care and improve outcomes depends on a better understanding of the pattern of medical referrals to the ICU for varying reasons of resource allocation, staffing, and quality improvement initiatives. This study aims to describe and provide valuable insights into the patterns of medical admissions to the intensive care unit (ICU), including case mixes, intensive care interventions, duration of stay, and outcomes to highlight the need for proper resource allocation.
A retrospective descriptive study was conducted at the University of Port Harcourt Teaching Hospital ICU between January 2022 and December 2024. We reviewed all patients from the Department of Internal Medicine referred to the ICU with a purely medical diagnosis. Data were retrieved from the ICU admissions register and patients' medical records following ethical exemption approval.
A total of 377 patients with medical referrals were reviewed, accounting for approximately 56.9% of all ICU admissions. More males were admitted, and the mean age of patients was 48.6 ± 15.3 years. The emergency unit was the commonest source of referral and offered a significant source of in hospital delays prior to transfer to the ICU. The most common indication for ICU admission was stroke, with hemorrhagic stroke, sepsis, and cardiogenic shock associated with the worst outcomes.
Stroke predominated medical referrals and provided the worst outcome. The in-hospital delays at the emergency unit which became the largest source of referral contributed to the high mortality. This study highlights the need to strengthen stroke care at the tertiary level of care as well as other medical referrals to improve care.
重症监护病房为重症患者提供专科护理，是现代医疗保健不可或缺的一部分。在资源有限的低收入国家，优化患者护理和改善治疗结果的需求取决于更好地了解因资源分配、人员配备和质量改进举措等不同原因而转诊至重症监护病房的医疗模式。本研究旨在描述重症监护病房（ICU）的医疗入院模式，并提供有价值的见解，包括病例组合、重症监护干预措施、住院时间和治疗结果，以突出合理资源分配的必要性。
2022年1月至2024年12月在哈科特港大学教学医院重症监护病房进行了一项回顾性描述性研究。我们回顾了内科转诊至重症监护病房且诊断为纯内科疾病的所有患者。经伦理豁免批准后，从重症监护病房入院登记册和患者病历中检索数据。
共审查了377例医疗转诊患者，约占所有重症监护病房入院患者的56.9%。男性入院患者更多，患者的平均年龄为48.6±15.3岁。急诊科是最常见的转诊来源，也是转入重症监护病房前院内延误的重要来源。重症监护病房入院最常见的指征是中风，出血性中风、脓毒症和心源性休克的治疗结果最差。
中风在医疗转诊中占主导地位，且治疗结果最差。急诊科成为最大转诊来源的院内延误导致了高死亡率。本研究强调需要加强三级医疗护理中的中风护理以及其他医疗转诊，以改善护理。
