Outcome of Patients Admitted to Intensive Care Unit in a Quaternary Care hospital

Background: Quality Improvement (QI) in intensive care unit (ICU) is directly dependent upon the outcome of patients treated in ICU. Poor quality of care not only increases morbidity and mortality but also increase expenses. Objective: To conduct an audit on patients admitted to our ICU to determine their outcomes in terms of mortality and length of stay. Methods: In this retrospective study, 330 patients who had been admitted to our intensive care unit (ICU) between December 1, 2022, and April 30, 2023, were reviewed. Patient's demographic data was collected, and correlation was done between the length of stay in ICU, APACHE II score and mortality using t-test. Results: Out of 330, there were 209 males (63.3%) and 121(36.7%) females, with mean age of 41.9+15.3 years. There were 63 medical patients (19.1%) and 267(80.9%) surgical patients, mainly liver and kidney transplant patients. Mean duration of ICU stay for survivors was 3.1+3.3 days vs 6.9+7.7 days for non- survivors (p-value 0.003) and overall mortality rate was 12.7%, mostly with end-stage liver or kidney diseases. In medical patients, the APACHE II score for survivors was 17.9+7.8 versus 24.5+9.6 in non- survivors (p-value 0.007), and for deceased medical patients it was 24.4+9.6 on admission and 31.8+8.9 after 48 hours of admission (p-value 0.001). While APACHE II score among deceased surgical patients was 19.5+3.7 on admission and 25.7+5.8 after 48 hours of admission (p-value 0.015). Most common cause of death was sepsis and multi-organ failure. Conclusion: This audit presents the profile of patients admitted in ICU of a quaternary level hospital of Pakistan, mainly catering advanced liver and kidney diseases including transplant. The commonest cause of death was septic shock and multi-organ failure. Higher APACHE II scores and longer ICU stay are the predictors of mortality among our patients.