Patterns of admission and clinical outcomes among patients admitted to the intensive care unit of Hetauda Hospital

Abstract

 Introduction: Intensive Care Units (ICUs) are critical components of healthcare systems, yet data on ICU admission patterns and clinical outcomes from peripheral hospitals in low-income countries like Nepal remain scarce. This study aimed to describe the pattern of admissions, interventions, and clinical outcomes among patients admitted to the ICU of Hetauda Hospital, Nepal. Methods: A hospital-based retrospective cross-sectional study was conducted in Hetauda Hospital over a 12-month period from November 2022 to November 2023. All admitted patients were included using total enumeration sampling. Patients with incomplete or missing records were excluded. Data were extracted from ICU logbooks, bedside charts, and discharge registers using a structured checklist and analyzed using descriptive statistics. Results: Of 1,071 admitted patients, 1,039 (97.0%) were included. The mean age was 54 ± 21 years, with females predominating, 600 (57.7%). The majority were admitted from the Medicine department, 807 (77.7%), and 664 (63.9%) were emergency admissions. Respiratory illness was the most common system involved, accounting for 322 (31.0%), with Acute Exacerbation of COPD as the leading diagnosis, at 234 (22.5%). Comorbidities were present in 263 (25.3%) patients. The overall mortality rate was 3.2%, and mechanical ventilation was required in 28 (2.7%) patients, with a mortality rate of 78.6% among ventilated patients. Conclusion: Respiratory illnesses were the predominant cause of ICU admission at this peripheral hospital in Nepal. The overall mortality was low at 3.2%, likely reflecting differences in patient demographics and case severity compared to higher-level facilities.