Outcome Of Trauma Admissions In An Intensive Care Unit In The Niger Delta Region Of Nigeria

Abstract

BACKGROUNDTrauma, mostly from head injuries, has been found to be the leading cause of admissions in an intensive care unit (ICU) in Nigeria. The outcome of management of patients with trauma in the ICU at the University of Port Harcourt Teaching Hospital (UPTH) is not known.OBJECTIVE The aim of this audit was to determine the outcome of management for trauma patients admitted in the ICU at UPTH, and how it could be improved.METHODSAll ICU admissions over a period of 4 years (February 2007-January 2011) at the UPTH were analyzed retrospectively. The proportion of these admissions that were due to trauma and the outcome were noted. Demographic details and other information were obtained from the admissions records of the patients and their case notesRESULTS A total of 529 patients were admitted. Two hundred and fifty four (48.0%) were males, while 275 (52.0%) were females. Their ages were between 4 months and 82 years. Postsurgical patients contributed 226 (41.4%) of all admissions, while 132 (25%) of the admissions were for trauma cases. Other reasons for admission included medical conditions, 109 (20.6%), and burns, 62 (11.7%). The length of stay in the unit ranged from one day to fifty-three days, with a mean of approximately 10 days. A total of 217 (41.02%) patients died in the hospital.Fifty-three (40.2%), of the132 trauma patients, died during admission in the ICU. Eighty-one (61.4%) of all trauma patients had head injury. Thirty-nine (48.1%), of all 81 head injury patients, died during admission. Thus, head injury was responsible for 39 (73.6%) of all 53 deaths caused by trauma.CONCLUSIONSHead injury was responsible for majority of the trauma admissions in the ICU. Mortality rate for trauma patients admitted in the ICU was very high. It was even higher for those patients admitted with head injury. Better therapeutic and monitoring equipment and further training of medical and nursing staff of the ICU are needed to reduce these high mortality rates. Also, improvement in the pre-hospital management of the trauma patient to prevent secondary brain injury can increase survival for head injured patients.