[Thirty years of intensive care. Clinical experience at Reykjavik Hospital.]

Reykjavik Hospital has been the main trauma center in Iceland. The Intensive Care Unit (ICU) was founded in 1970 and has been in operation since then. The aim of this study was to review its clinical experience these 30 years.

A retrospective study of patient records was conducted for all admissions to the ICU between 1970 and the end of 1999. Data was collected pertaining to the annual rate of admission, proportion of patients requiring ventilator treatment, mortality rate, age distribution, reasons for admission and medical speciality.

A total of 13,154 patients were admitted to the ICU between 1970 and the end of 1999. A steady increase in the rate of admissions was observed during the study period, reaching 550-600 patients for the ICU annually. There was a statistically significant increase in the proportion of patients requiring ventilator treatment over the study period, reaching 38% of ICU admissions by the end of the study. During the study period only one statistically significant change was observed in age distribution. The annual rate of admission to the ICU for patients over 60 years of age increased significantly between the periods 1985-1989 and 1990-1999. The proportion of surgical patients increased (70% of patients by the end of the study) and the proportion of medical patients decreased (ending at 30% of patients). During the last decade a significant increase was seen in patients admitted after major surgery. The observed mortality rate in the final years of the study was observed to be significantly less than it had been in previous years. The observed mortality rate from 1970 to 1989 was 11.7% of patients, decreasing to 8.6% from 1990 to 1998. The average length of stay was also observed to decline.

The decline in mortality occurred in spite of an increased rate of admission and an increased workload. This change is attributed to improvement in the care of critically ill patients over the study period.