Key result
Endotracheal intubation was the most significant predictor of mortality (p=0.001) among cardio-thoracic patients admitted to the ICU, who experienced an overall mortality rate of 15%.
Observational (n=96)
No
p-value: p=0.001
Cardio-thoracic patients have high ICU utilization primarily for post-operative care, with endotracheal intubation being a significant predictor of mortality, suggesting a potential role for High Dependency Units (HDU) for selected cases.
Intubation flags high-risk cardio-thoracic ICU patients; observational data leave open whether selective HDU use improves survival.
BACKGROUND: The underlying pathological conditions in cardio-thoracic patients, anesthetic and operative interventions often lead to complex physiological interactions that necessitate ICU care. Our objectives were to determine the intensive care unit (ICU) utilization by cardio-thoracic patients in our centre, highlight the common indications for admission; and evaluate the interventions provided in the ICU and the factors that determined outcome. MATERIALS AND METHODS: The intensive care unit (ICU) records of University College Hospital, Ibadan for a period of 2 years (October 2007 to September 2009) were reviewed. Data of cardio-thoracic patients were extracted and used for analysis. Information obtained included the patient demographics, indications for admission, interventions offered in the ICU and the outcome. RESULTS: A total of 1, 207 patients were managed in the ICU and 206 cardio-thoracic procedures were carried out during the study period. However, only 96 patients were admitted into the ICU following cardio-thoracic procedures, accounting for 7.9% of ICU admissions and 46.6% of cardio-thoracic procedures done within the review period. The mean length of stay and ventilation were 5.71 ± 5.26 and 1.30 ± 2.62 days. The most significant predictor of outcome was endotracheal intubation (P = 0.001) and overall mortality was 15%. CONCLUSION: There is a high utilization of the ICU by cardio-thoracic patients in our review and post-operative care was the main indication for admission. Some selected cases may be managed in the HDU to reduce the burden on ICU resources. We opine that when endotracheal intubation is to continue in the ICU, a 1:1 patient ratio should be instituted.
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Osinaike et al. (2012) conducted an observational in Cardio-thoracic procedures requiring ICU admission (n=96). Endotracheal intubation vs. No endotracheal intubation was evaluated on Mortality (p=0.001). Endotracheal intubation was the most significant predictor of mortality (p=0.001) among cardio-thoracic patients admitted to the ICU, who experienced an overall mortality rate of 15%.
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