[Previous article][Contents][Next article]
A retrospective study to collect data on patient demographics and cause of admission to the Intensive Therapy Unit (ITU) of St. Vincent's Hospital was conducted. Information was correlated using a data base and spread sheet programme. The results indicated that 354 patients (235 male, 119 female) were admitted over a 6 month period, 1.7.89 to 31.12.89. Ages ranged from 14 to 84 years, with an average of 52 years. Admissions were classified under 19 primary diagnoses. Neurology and Vascular patients comprised 50% of total admissions. Admissions to ITU were largely (40%) post operative surgical patients. Suggestions are offered for further study.
|
Michael Draheim, RN, Dip. App. Se. (Nursing), Intensive Therapy Certificate. Michael has worked in Intensive Care for a number of years. He is currently working as a Clinical Nurse Specialist In the Intensive Therapy Unit at St. Vincent's Hospital, Sydney. This study was undertaken as part of the Intensive therapy Course, 1989-90 at St. Vincent's Hospital, Sydney. |
[top]
This study was based on the number of patients who were admitted to the Intensive Therapy Unit (ITU) of St. Vincent's Hospital Sydney, over a six month period. from 01.07.89 to 31.12.89. Although it is a 15 bed unit with nine main unit beds and six isolation unit beds, the ITU was functioning at a nine bed level in total during the study period.
The patients admitted to the unit are those with major problems of either medical or surgical (excluding cardiothoracic) origin and some major trauma.
The purpose of this study was to discover the following factors: the number of patients admitted to ITU, reason for admission, the age of patients, their sex and length of stay in ITU and the total length of their stay in hospital. It was proposed that a number of useful facts may be drawn from this information once the data had been correlated. It is suggested that the data is of value to unit staff, administrators and educators as it provides for increased awareness of the utilisation of the unit and specifically, the types of patients cared for.
Excluded from this study were patients who were admitted before 01.07.89 but were inpatients between July and December, 1989. Patients admitted to ITU during the six month period, who were still inpatients either in the hospital or ITU after 31.12.89, were included.
[top]
During the chosen 6 month period, 354 patients were admitted to ITU, of these, 235 were male and 119 were female.
The youngest male admission to the unit was 14 years old, however. a male baby was born in the unit to a mother suffering multiple sclerosis. The oldest male was 80 years old. The youngest female was 21 years old and the oldest 84 years. The average overall age was 52 years, however nearly 60% were 50 years or more, with 40% being over 60 years old (see Figure 1). At the other end of the scale, only 2.5% were under the age of 20 years.
Figure 1. Age distribution of patients admitted to the unit
The 354 admissions to ITU were classified under 19 primary diagnoses. The 12 'major' diagnoses are depicted in figure 2, The remainder classified as 'minor' diagnoses, for convenience, are depicted in figure 3.
Figure 2. 'Major' admissions to ITU
Figure 3. 'Minor' Admissions to ITU 1.7.89 - 31.12.89
Neurology and Vascular patients together comprised 50% of the total number of admissions to ITU - 31% and 19% respectively.
The 'Neurology' admissions can be broken down into 59% Medical admissions comprising patients with closed head injuries, subarachnoid haemorrhage. Guillian-Barre syndrome, fitting, fractures of the spine, intercranial haemorrhages or loss of consciousness for unknown reason) and 40% Surgical admissions. comprised of patients after clipping of aneurysms, removal of tumours, evacuation of haematomas and subdurals or acoustic neuromas.
Total number of Neurology patients was 110, 14 of whom died.
Neuromedical Patients:
Data available did not reflect length of stay compared with severity of the disease or illness, nor complications which may have affected each patient's length of stay.
Neurosurgical Patients:
Of the 67 'Vascular' patients, 3 Vascular Medical patients had an average length of stay of 2.6 days. The 64 'Vascular Surgical' patients were divided into three groups: Aortic aneurysms, Carotid surgery and other, such as Femoral Bypass surgery (figure 4).
Figure 4. Vascular Admissions to ITU 1.7.89 - 31.12.89
The 'Aortic Aneurysm Group' (n=35) had an average length of stay of 4.1 days. All but one of these patients stayed 8 days or less; an 80 year old patient died after an 18 day stay, occasioned by emergency repair of a leaking aortic aneurysm. The only other death (at 7 days) in this category was also a male of 80 years. The 'Carotid Surgical Group' (n=21) recorded the most stable length of stay of 2 days for all patients. 'General Vascular Surgery' patients (n=8) stayed an average of 2.6 days. The longest stay was of 4 days, shared by 3 of the patients.
Figure 5. Number of Deaths in ITU 1.7.89 - 31.12.89
The total number of deaths in ITU was 51 (see figure 5). This figure represents 14.5% of the total six month population. The highest number of deaths (12) occurred in October and the least (4) during November. 17.4% of the male population (41), and 8.4% (10) of the female population died. Three of the six males of 80 years and over died. whilst no females In this age group died. The youngest female death was that of a 36 year old neurosurgical patient who coned. whilst the youngest male death was an 18 year old who arrested as a result of heroin overdose.
Admissions to ITU largely comprise of post-operative surgical patients, representing 40% of admissions. 30% are admitted through the Accident and Emergency Centre. The majority of patients are discharged from ITU to four main areas:
[top]
[top]
Due to the large proportion of Neurology patients nursed in the ITU, a closer relationship with the Neurology ward staff may be beneficial for mutual understanding and cooperation.
Data obtained from this study could be used in the development of a patient classification system, by its provision of patient demographics. This data is currently being used to assist in a hospital funded research programme.
Suggestions for future research include:
[top]
