OBJECTIVE: This study was conducted to ascertain the causes of death and mortality rate in patients admitted to medical intensive care unit (ICU) of Khan Research Laboratories (KRL) Hospital, Islamabad, Pakistan.
METHOD: Current study enrolled 775 patients admitted in Medical ICU of KRL Hospital, Islamabad, Pakistan from April 16, 2016 till April 16 2017. KRL Hospital is a 350 bedded hospital and has a 13-beded level II ICU. This was a descriptive study involving non-probability consecutive sampling. Statistical analysis was done using statistical package for social sciences (SPSS version 20).
RESULT: Out of 775 patients, 125 (16.1%) patients died. Out of these 125 patients, 68 (54.4%) were males and 57 (45.6%) were females. Majority of patients (n=69; 55.2 %) were ranging in age from 71-100 years of age, while 37 (29.6%) patients were ranging in age from 56-70 years and 19 (15.2%) were less than 55 years of age. Among the deceased, pneumonia was the most common reason (n=49; 39.2 %) for admission followed by urinary tract infection (n=16; 12.8%) and septicemia (n=14; 11.2%). Hypertension (n=33; 26.4%) was the most common co-morbid followed by diabetes mellitus (n=24; 19.2 %) and ischemic heart disease (n=18; 14.4 %).
CONCLUSION: More than half of deceased patients admitted to ICU had age more than seventy years. Sepsis related conditions were responsible for death in more than sixty percent of patients. Majority of patients had diabetes mellitus, hypertension or ischemic heart disease as co-morbid conditions.
KEY WORDS: Intensive Care Unit (ICU) (MeSH); Mortality (MeSH); Sepsis (MeSH); Pneumonia (MeSH); Hypertension (MeSH); Diabetes Mellitus (MeSH).
Pakistan Bureau of Statistics, Government of Pakistan. Islamabad district at a glance. [Online]. [Cited on May 30, 2017: ]. Available from URL: http://www.pbs.gov.pk/sites/default/files//tables/District%20at%20glance%20Islamabad.pdf
Baker T, Lugazia E, Eriksen J, Mwafongo V, Irestedt L, Konrad D. Emergency and critical care services in Tanzania: A survey of ten hospitals. BMC Health Serv Res. 2013 Apr 16;13:140. DOI: 10.1186/1472-6963-13-140.
Baelani I, Jochberger S, Laimer T, Otieno D, Kabutu J, Wilson I, et al. Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care 2011;15:R10. DOI: 10.1186/cc9410.
Frikha N, Mebazza M, Mnif L, El Euch N, Abassi M, Ben Ammar MS. Septic shock in a Tunisian intensive care unit: mortality and predictive factors. 100 cases. La Tunisie Medicale 01 June 2005;83(6): 320–325.
Dünser MW, Baelani I, Ganbold L. A review and analysis of intensive care medicine in the least developed countries. Crit Care Med 2006 Apr;34(4):1234–42. DOI: 10.1097/01.CCM.0000208360.70835.87.
McCrossan L, Bickerstaffe W, Mostafa SM, Anderson L, Cheater L, Jayson D, et al. Referrals to intensive care: A region-wide audit. Crit Care 2007;11(1):403. DOI: 10.1186/cc5134.
De Jonge E, Bosman RJ, van der Voort PH, Korsten HH, Scheffer GJ, de Keizer NF. Intensive care medicine in the Netherlands, 1997–2001. I. patient population and treatment outcome. Ned Tijdschr Geneeskd 2003 May 24;147(21):1013–7.
Moran JL, Bristow P, Solomon PJ, George C, Hart GK, Australian and New Zealand intensive care society database management committee (ADMC). Mortality and length-of-stay outcomes, 1993–2003, in the binational Australian and New Zealand intensive care adult patient database. Crit Care Med 2008 Jan;36(1):46–61. DOI: 10.1097/01.CCM.0000295313.08084.58.
Jacob ST, Moore CC, Banura P, Pinkerton R, Meya D, Opendi P, et al. Severe sepsis in two Ugandan hospitals: a prospective observational study of management and outcomes in a predominantly HIV-1 infected population. PLoS One 2009 Nov 11;4(11):e7782. DOI: 10.1371/journal.pone.0007782.
Kwizera A, Dünser M, Nakibuuka J. National intensive care unit bed capacity and ICU patient characteristics in a low income country. BMC Res Notes 2012 Sep 1;5:475. DOI: 10.1186/1756-0500-5-475.
Qadeer A, Akhtar A, Qurat Ul Ain, Saadat S, Mansoor S, Assad S, et al. Antibiogram of medical intensive care unit at tertiary care hospital setting of Pakistan. Cureus 2016 Sep; 8(9): e809. DOI: 10.7759/cureus.809
Phua J, Koh Y, Du B, Tang YQ, Divatia JV, Tan CC, et al. Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ 2011 June 13; 342:d3245. DOI: 10.1136/bmj.d3245.
Costa e Silva VT, de Castro I, Liaño F, Muriel A, Rodríguez-Palomares JR, Yu L. Performance of the third-generation models of severity scoring systems (APACHE IV, SAPS 3 and MPM-III) in acute kidney injury critically ill patients. Nephrol Dial Transplant 2011 Dec;26(12):3894-901. DOI: 10.1093/ndt/gfr201.
Soares M, Silva UV, Teles JM, Silva E, Caruso P, Lobo SM, et al. Validation of four prognostic scores in patients with cancer admitted to Brazilian intensive care units: results from a prospective multicenter study. Intensive Care Med 2010 July;36(7):1188-95. DOI: 10.1007/s00134-010-1807-7.
Wu VC, Tsai HB, Yeh YC, Huang TM, Lin YF, Chou NK, et al. Patients supported by extracorporeal membrane oxygenation and acute dialysis: acute physiology and chronic health evaluation score in predicting hospital mortality. Artif Organs 2010 Oct;34(10):828-35.
Maccariello E, Valente C, Nogueira L, Bonomo H, Ismael M, Machado JE, et al. SAPS 3 scores at the start of renal replacement therapy predict mortality in critically ill patients with acute kidney injury. Kidney Int. 2010 Jan;77(1):51-6. DOI: 10.1038/ki.2009.385.
McCrossan L, Bickerstaffe W, Mostafa SM, Anderson L, Cheater L, Jayson D, et al. Referrals to intensive care: A region-wide audit. Crit Care 2007;11(1): 403. DOI: 10.1186/cc5134
Shafiq F, Ijaz AU, Kashif MA, Zafar S, Shahzad SI. Chronic liver disease related admissions and mortality pattern in medical ICU. Pak J Gastroenterol Mar 2006;20(1):72-4.
Shoukat H, Muhammad Y, Gondal KM, Aslam I. Mortality Prediction in Patients Admitted in Surgical Intensive Care Unit by Using APACHE IV. J Coll Physicians Surg Pak. Nov 2016;26(11):877-80.
Zeng A, Song X, Dong J, Mitnitski A, Liu J, Guo Z, et al. Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit. J Gerontol A Biol Sci Med Sci. 2015 Dec;70(12):1586–94. DOI: 10.1093/gerona/glv084.
Azoulay E, Adrie C, De Lassence A, Pochard F, Moreau D, Thiery G, et al. Determinants of postintensive care unit mortality: a prospective multicenter study. Crit Care Med. 2003 Feb;31(2):428–32. DOI: 10.1097/01.CCM.0000048622.01013.88
Work published in KMUJ is licensed under a
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.