Prolonged stay in the Intensive Care Unit of a tertiary hospital in Nigeria: Predisposing factors and outcome

Background: Prolonged stay in the Intensive Care Unit (ICU) defined ≥14 days stay in the ICU is associated with increased cost, resource utilization, and could contribute to patients' morbidity and mortality. Objective: This study was designed to determine the factors that contributed to prolonged stay in ICU and its impact on patients' outcome. Materials and Methods: We conducted an 11-year retrospective, case-control study of all admissions into the ICU with emphasis on prolonged stay. Data on indications for ICU admission, clinical course, and intervention in terms of blood transfusion and mechanical ventilation were obtained and analyzed. Others were duration of stay in the ICU and patients' outcome. Results: A total of 1,661 patients were admitted into the ICU during the study period, out of which only 90 patients had prolonged stay constituting 5.4%. Mortality rate among patients with prolonged stay was 37.8%. Neurosurgery and cardiothoracic units had more patients with prolonged stay, 38.6% and 18.2% patients, respectively. Blood transfusion and the indication for ICU admission contributed significantly to prolonged stay. Conclusion: The ICU exerts great physical, material, psychological, and social toll on the patients, institution, and society. Indication for ICU admission/severity of illness and blood transfusion were identified factors associated with prolonged stay in the ICU. Age, sex, and mechanical ventilation did not have any significant impact on duration stay.