Burden and Outcomes of Cardiovascular Diseases in the ICU of a Nigerian Tertiary Hospital.

INTRODUCTION

The rising prevalence of cardiovascular diseases in Nigeria makes it imperative to develop specialised cardiac intensive care units (CICU) with uniquely trained staff for the management of critically ill cardiac cases that are currently being managed in the general ICU. This study aimed to describe the clinical characteristics and outcomes of patients with cardiac disease admitted into the ICU of the University of Port Harcourt Teaching Hospital.

METHODS

This was a retrospective cross-sectional hospital-based study. The records of medical patients admitted into the ICU from January 2019 to December 2023 were studied. Patients' biodata, clinical information, and outcomes were extracted. Data was analysed using SPSS version 25 (IBM Corp., Armonk, NY).

RESULTS

Cardiac diseases accounted for 91 (28.0%) of the 325 medical patients admitted into the ICU with a mean age of 55.9±17.4years, and 46 (50.5%) were men. Hypertensive emergencies were the commonest cardiac indication for admission in 29 (31.9%) persons, followed by acute decompensated heart failure (ADHF) and pulmonary embolism in 24(26.4%) and 22 (24.2%) persons, respectively. Others included cardiogenic shock in nine (9.9%), unstable arrhythmias in five (5.5%), and acute myocardial infarction in two (2.2%) patients. A total of 50 (54.9%) persons admitted for cardiovascular disease died, with a significant relationship between increasing age (p=0.046), use of ionotropic/vasoactive medication (p=0.002), and use of mechanical ventilation (p=0.048) with mortality.

CONCLUSION

Hypertensive emergencies and ADHF emerged as significant contributors to cardiac morbidity and mortality in the ICU. This data may be useful to guide cardiac critical care redesign to improve patient outcomes.