Outcome evaluation of a South African ICU - a baseline study

Objectives. To describe the baseline data of patients admitted to the surgical intensive care unit in a tertiary hospital in the Western Cape, and their outcome at discharge from the ICU. Design. Prospective cohort observational study. Setting. Ten-bed closed surgical unit in a university-affiliated tertiary hospital. Sample. One hundred and sixty consecutive adult ICU admissions from 16 June to 30 September 2003. Measurements. Demographic information, admission diagnosis, surgery classification (elective or emergency) and co-morbidities were recorded on admission to the unit. APACHE II score was calculated. The two outcomes of ICU length of stay (LOS) and mortality were recorded on discharge from the unit. Results. Patients were 49 ± 19.95 years of age. The mean APACHE II score was 12.3 ± 7.19 and 12.3% mortality was observed. The standardised mortality ratio was 0.87. Patients stayed in the unit for 5.94 ± 6.55 days. Hypertension was the most frequent co-morbidity found in this cohort (42%), and 21% (N = 5) of patients tested were HIV positive. Neither age, gender nor co-morbidities had any significant association with mortality or ICU LOS (p > 0.01). A significant correlation was established between APACHE II scores, mortality and ICU LOS (p < 0.001). Conclusions. This baseline study of a surgical ICU in a tertiary environment in the Western Cape presents a picture of a unit providing care comparable to First-World environments. It is debatable whether the current admission and discharge criteria are making optimal use of the technology available in a level 1 intensive care unit. Other cost-effective ways of managing patients who are not as ill could be investigated. Southern African Journal of Critical Care Vol. 22 (1) 2006: pp. 14-20