National intensive care unit bed capacity and ICU patient characteristics in a low income country
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Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
BMC research notes
Abstract
Primary health care delivery in the developing world faces many challenges. Priority setting favours
HIV, TB and malaria interventions. Little is known about the challenges faced in this setting with regard to critical
care medicine. The aim of this study was to analyse and categorise the diagnosis and outcomes of 1,774 patients
admitted to a hospital intensive care unit (ICU) in a low-income country over a 7-year period. We also assessed the
country’s ICU bed capacity and described the challenges faced in dealing with critically ill patients in this setting.
Findings: A retrospective audit was conducted in a general ICU in a university hospital in Uganda. Demographic
data, admission diagnosis, and ICU length of stay were recorded for the 1,774 patients who presented to the ICU in
the period January 2003 to December 2009. Their mean age was 35.5 years. Males accounted for 56.5% of the study
population; 92.8% were indigenous, and 42.9% were referrals from upcountry units. The average mortality rate over
the study period was 40.1% (n = 715). The highest mortality rate (44%) was recorded in 2004 and the lowest (33.2%)
in 2005. Children accounted for 11.6% of admissions (40.1% mortality). Sepsis, ARDS, traumatic brain injuries and HIV
related conditions were the most frequent admission diagnoses. A telephonic survey determined that there are
33 adult ICU beds in the whole country.
Conclusions: Mortality was 40.1%, with sepsis, head injury, acute lung injury and HIV/AIDS the most common
admission diagnoses. The country has a very low ICU bed capacity. Prioritising infectious diseases poses a challenge
to ensuring that critical care is an essential part of the health care package in Uganda
Description
Keywords
Intensive care medicine, Diagnosis, Uganda, Low-income country, Mortality
Citation
Kwizera, A., Dünser, M., & Nakibuuka, J. (2012). National intensive care unit bed capacity and ICU patient characteristics in a low income country. BMC research notes, 5(1), 1-6.