Specialty utilization of a multidisciplinary Intensive Care Unit in a resource-limited Tertiary Hospital in Nigeria: A Five-Year Retrospective Review
Abstract
Background: Intensive care unit (ICU) admission patterns reflect the burden of critical illness and guide resource allocation. Data from tertiary centres in Nigeria remain limited, particularly in the South-East. Objectives: This study described the demographic profile, specialty referral patterns, diagnostic distribution, temporal trends, outcomes, and ICU length of stay at Federal Medical Centre, Umuahia, over five years. Methods: A retrospective review of all ICU admissions from January 2020 to December 2024 was conducted. Data on demographics, referring specialty, primary diagnosis, annual volumes, outcomes, and length of stay were analysed descriptively. Results: A total of 778 patients met inclusion criteria. The mean age was 39.0 ± 23.7 years, with males predominating (56.7%). Age distribution was as follows: 0–17 years, 21.2% (n = 165); 18–39 years, 31.1% (n = 242); 40–59 years, 23.1% (n = 180); and ≥60 years, 24.6% (n = 191). Adults (≥18 years) comprised 78.8% of admissions overall. Annual admissions increased from 85 in 2020 to 308 in 2023, then declined to 119 in 2024. Neurosurgery was the leading specialty (29.9%; 95% CI: 26.8–33.3), followed by general surgery (19.2%) and internal medicine (15.0%). Severe traumatic brain injury was the most frequent diagnosis (10.29%), followed by sepsis (9.90%) and cerebrovascular accident (6.04%). Neurological/neurosurgical conditions accounted for 30.33% (n = 236) of admissions. Overall ICU mortality was 45.1% (n = 351), with survival in 54.9% (n = 427). Mortality was higher among paediatric patients (49.7%) than adults (43.9%). ICU stay was right-skewed (Shapiro–Wilk p<0.05), median 5.0 days (IQR: 3.0–11.0), mean 8.8 ± 10.7 days, maximum 48 days. Conclusion: ICU admissions were dominated by young adult males, surgical referrals, and neurotrauma. Mortality remained high, especially in paediatrics, with variable but typically short ICU stays, underscoring the need for strengthened critical care capacity.