Morbidity and Mortality in the Surgical ICU: A Retrospective Audit in a Tertiary Care Center of a Developing Country
Delvene Soares*, Rizwan Sultan, Noman Shahzad and Hasnain Zafar
Journal Title:Medical & Clinical Research
Introduction: Patients admitted to the surgical intensive care units (SICUs) pose a significant burden on both the health care services and the economy. In our institution and moreover in our part of the world, data concerning the morbidity and mortality in these patients is unknown. With an increasing number of patients admitted to the service, figures need to be calculated to establish guidelines and quality indicators. Objectives: This study aims to calculate the risk of infectious complications in the SICU, and to calculate the mortality rate and ratio. Materials and methods: This is a retrospective review of patients admitted to the SICU at the Aga Khan University Hospital from January 2010 to December 2014. Only adult general surgery and trauma patients were included. Data was collected about the types of morbidities, the mortality rate and different factors that affect this rate. The standardized mortality ratio (SMR) was also calculated. Results: A total of 243 patients were included. The mean age was 49 ± 18 years. ER admissions comprised of 89% of patients with 67% having planned ICU admission. The average length of ICU stay was 5.57 days. The mean APACHE II score was 19.59. Hospital/ventilator-associated pneumonia was seen in 33%, blood stream infections in 27%, central line infections in 4% and catheter-associated urinary tract infections in 13%. The mortality rate was 45.3%. Age, unplanned ICU admissions and non-trauma admissions were found to be significantly associated with mortality (P <0.05). The SMR was 1.81 for operative cases and 1.36 for non-operative cases. Conclusion: Our mortality rate and SMR is high when compared to international institutions – this could be due to the paucity of regional data for comparison. Our study highlights the benefit of a planned ICU admission and set criteria should be established to define which patients need critical care.