Pattern and outcome of admitted cases to Pulmonary Intensive Care Unit in a tertiary care centre of Punjab
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2018, Vol 6, Issue 4
Abstract
Background: Early appropriate referral of patients to an ICU can significantly reduce mortality in critically ill patients. At the same time improper selection of patients for ICU often limits bed availability in ICU. Aim: To study pattern and outcome of patients admitted to pulmonary ICU. Material and methods: The present study was conducted in the department of pulmonary medicine, Guru Gobind Singh Medical College and hospital, Faridkot, Punjab and included assessment of patients admitted to medical and pulmonary ICU because of various respiratory diseases.A total of 100 patients with various respiratory diseases were included in the present study.The present study was conducted in the department of pulmonary medicine, Guru Gobind Singh Medical College and hospital, Faridkot, Punjab and included assessment of patients admitted to medical and pulmonary ICU because of various respiratory diseases.A total of 100 patients with various respiratory diseases were included in the present study.Results:COPD was the most prevalent respiratory disease in the present study found in 29 (29%) patients, followed by Bronchial asthma(19%), Pneumonia(17%), Pneumothorax(12%), Pulmonary TB (10%), Bronchiectasis(6%), Chronic Empyema(5%) and ILD(2%). In 26% patients, invasive ventilation was given while in remaining 74% patients, non-invasive ventilation was given. Death occurred in 25% patients while the 54% patients were discharged in satisfactory condition and 21% were discharged on request . Nosocomial infection present in 15% patients. Staphylococcus aureus was the most common nosocomial organism isolated in 5% followed by H. Influenzae in 3% and Streptococcus pneumonia in 3% of patients.76% of the patients had Comorbidities and type 2 DM was the most common comorbidity present in 19% of the cases . Shortest mean duration of ICU stay was for patients with ILD(4.5) followed by Pneumothorax(4.75), Bronchial Asthma(4.84), COPD(4.9), Bronchiectasis(5.5), Chronic empyema(5.6), Pneumonia(6.17) and Pulmonary TB(10). Mortality rate for Pulmonary TB was70% followed by ILD(50%), Chronic Empyema(40%), Bronchiectasis(33.33%), Pneumothorax(25%), Pneumonia(23.53%), COPD(13.79%) and Bronchial asthma(10.53%). Mortality in patients given invasive ventilation was more 19/26 (73.07%) than with non invasive ventilation 6/74 (8.11%). Conclusion: Owing to least mortality and shorter duration of ICU stay, patients with bronchial asthma and COPD should be preferred for pulmonary ICU followed by pneumothorax and pneumonia, which must be preferred over bronchiectasis, chronic empyema and ILD. Pulmonary TB must be given least preference. This message should be directed to all hospitals, primary care, private clinics physicians for respiratory critical cases referral to Pulmonary ICU, as this improves the outcome of patients and limits the economics of their management.
Authors and Affiliations
Saurav Gupta, GC Ahir, SK Bansal
Keywords
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