Impacts of ramadan on intensive care unit admission patterns and outcomes

Ramadan fasting is a religious obligation for healthy adult Muslims. Even though those unable to fast are exempt, many individuals refuse this authorization and insist to fast. This may lead to life threatening conditions and an increase in intensive care unit (ICU) demand.

To investigate the impacts of lifestyle changes during Ramadan on ICU admission patterns and outcomes.

It was a retrospective study carried out in the medical ICU of Farhat HACHED teaching hospital (Sousse, Tunisia). Patients who were admitted to the ICU during Ramadan (G2), Chaaban (G1), and Shawal (G3) over a period of 10 years were included. Demographic, clinical features and outcomes were compared.

During the review period, 748 patients were included (G1=257; G2=230 and G3=261). Compared to Chaaban, during Ramadan and Shawal, the percentages of admitted patients with, chronic kidney disease (CKD) (2.3, 3.5 and 7.3%, respectively) and for hypovolemic shock (1.6, 6.1 and 5.0%, respectively) were significantly higher. Furthermore, compared to Chaaban, during Ramadan and Shawal, patients were more likely to have inverted urinary sodium to potassium ratio (28.3, 48.7, 36.8% respectively). There was no significant difference in length-of-stay nor in mortality between the three months' periods.

While there were no differences in any studied outcomes in patients admitted to ICU before, during or after Ramadan, there was a significant increase in patients presenting with past history of CKD, hypovolemic shock and inverted urinary sodium to potassium ratio.