Medical intensive care unit utilization in an acute teaching hospital

To ascertain the profile of medical intensive care unit (MICU) utilization in the Singapore General Hospital, a prospective survey studying 162 consecutive patients admitted to MICU was conducted over a four-month-period spanning September through December 1990. While there was no racial predilection, male admissions (n = 98) outnumbered female (n = 64) by a ratio of 3:2. Male admissions averaged 56.7 +/- 1.9 years (mean +/- SEM) vs 56.4 +/- 2.69 years in female (p = 0.98). Sepsis comprised 25.3% (n = 41) of admissions during this period of which chest infection (n = 26) made up 63%. The superinfection rate was 3% comprising colonization of endotracheal and peritoneal dialysis tubes by Candida and Acinetobacter. There was a surprisingly high number of culture negative infections. These amounted to 43.9% (n = 18) out of 41 admissions for sepsis as the primary indication and 57.1% of admissions in which sepsis was an accompaniment of the main indication. The mean duration of ICU stay was 7.17 +/- 1.5 days for sepsis vs 4.7 +/- 0.5 days for admissions other than sepsis. Although this did not reach statistical significance (p = 0.79) it corroborates the prevalent impression that patients with sepsis tend to require longer intensive care. The overall mortality was 37% (n = 60). The mortality for septic patients (42.5%) is alarmingly high. This contrasts with a mortality rate of 34.7% for non-septic patients. The issue of culture negative sepsis needs to be addressed. As it stands, septic patients stay longer than non-septic ones.(ABSTRACT TRUNCATED AT 250 WORDS)