Demographics and Outcome of Referrals of Critically Ill Patients from a University Teaching Hospital, Uyo, South – South, Nigeria

Abstract

Background: Referral of critically ill patients from one centre to another is an integral part of healthcare system. Aims: To evaluate the outcome of referral practices from the Intensive Care Unit of the University of Uyo Teaching Hospital. Patients and Methods: This was a retrospective study of all consecutive critically ill patients referred from the intensive care unit (ICU) of the University of Uyo Teaching Hospital, Uyo, to other hospitals between January 2009 – December 2014. All patients studied were transferred by medical personnel in either land or air ambulances. The primary and secondary outcomes measured were whether the patients received the proposed treatment and mortality respectively. Data from the referring centre were obtained from the ICU admission and discharge register and patient’s folder, while data during transfer and outcome were obtained from the accompanying medical personnel and patient’s family members. Data analysis was done using SPSS version 16. Results: Thirteen patients referred were analysed. Majority of the patients (77%) were referred for neurosurgical review, mechanical ventilation and CT-Scan and/or MRI. Two patients were referred for specialized burns care, and one patient for radiotherapy. Seven patients (54%) were transferred with land ambulance, while six (46%) were transferred with air ambulance. Regarding outcome, eight (62%) patients were successfully transferred to their destination hospitals, and all received proposed treatment. A total of three patients survived while ten died, thus giving an overall mortality rate of 77%. Conclusion: The outcome of critically ill patients referred from our centre to other hospitals is poor. Therefore, appropriate personnel should be employed and equipment provided in our centre to manage the patients.