Patterns of Intensive Care Unit Mortality from Natural Causes at a Tertiary Care Centre in Western Nepal: An Observational Study

TL;DR

This study analyzed ICU mortality patterns in a hospital in western Nepal, finding higher mortality among males and seasonal clustering of deaths.

Contribution

The study provides insights into ICU mortality patterns and sex-based differences in a resource-limited setting in Nepal.

Findings

Males constituted the majority (54.88%) of ICU mortality cases.

Mortality clustered between August and November, with peaks in September and November.

Diabetic patients had a higher median age and higher systolic blood pressure compared to non-diabetic patients.

Abstract

Intensive care units (ICUs) play a vital role in managing critically ill patients, but mortality rates remain high, especially in resource-limited settings like Nepal. This study aimed to describe the patterns and clinical characteristics of mortality cases in the ICU of a tertiary care hospital in western Nepal, with specific focus on sex-based differences and their associated comorbidities.

A retrospective study was conducted at Lumbini Medical College Teaching Hospital, Nepal, over a one-year period (January 1 to December 31, 2024). This record-based study included mortality data of all ICU patients who died during their hospital stay and had complete medical records. Data on demographics, clinical parameters, comorbidities, laboratory findings, and need for mechanical ventilation were extracted using a structured proforma.

A total of 82 (21.93%) ICU mortality cases were included out of 374 ICU admissions, consisting of 45 (54.88%) male and 37 (45.12%) female. Median age was 63 (IQR: 46-73) years in males and 70 (IQR: 58-78) years in females. There was clustering of mortality, with 13 (15.85%) deaths occuring in September and 11 (13.41%) in November. The median age of diabetic patients was 72 (IQR: 66-77) years, while the median age of non-diabetic patients was 57.50 (IQR: 44 -73.50) years. The mean systolic blood pressure in diabetic patients was 117.79±22.64 mmHg, and in non-diabetic patients was 102.35±30.20 mmHg.

The clustering of mortality was seen during a four-month period from August through November. Male patients constituted a majority of ICU deaths due to natural causes.