Intensive care unit admission trends among surgical patients: insights and recommendations from two regional referral level hospitals in Tanzania

Abstract

Background: The ongoing needs of surgical services in Tanzania has attracted the necessity to address practical challenges faced in the provision of surgical care. The challenges are not only limited to the respective human resources, but also to the essential surgical-medical amenities like an Intensive Care Unit (ICU) which functions as a bay for optimization and post-operative care for the critical surgical patients. Methods: A two-center prospective longitudinal study was conducted from April 2024 to January 2025. Standardized checklist was used to collect data from eligible patients in the Intensive Care Units of the two hospitals. Data were descriptively summarized and chi square test was used to assess for association between variables, p-value of < 0.05 was considered statistically significant. Results: Most of the patients were admitted from Theatre (43, 40.19 %) with trauma being the leading diagnosis (51, 47. 66%). The mean ICU duration of stay was 6.58 days (3.03 SD) whereby 59.81 % of all admissions were transferred to normal ward post stabilization. Indication for admission, comorbid conditions and duration of stay were significantly associated to the outcomes of interest with the p values of < 0.001, 0.02 and 0.01 respectively. Conclusion: The observed trends of admission in the ICU stresses on the importance of having a stable unit capable of rendering essential critical care to surgical patients. Furthermore; the establishment of a High Dependency Unit (HDU) in surgical wards will significantly reduce unnecessary admissions and work-load to the Intensive Care Unit.