Evaluating the impact of the primary reason for admission on ICU outcomes: A Retrospective study

Abstract

Introduction: Understanding factors that influence patient outcomes in the intensive care unit (ICU) is important for improving care and resource utilization. This study aimed to investigate whether the primary reason for admission affects length of stay and other outcomes in the ICU.
Methods: This was a retrospective study conducted at 26 hospitals in Saudi Arabia. Data were collected on 1,491 adult patients admitted to the ICUs between September, 2020 and December, 2020. The primary variables analyzed were ICU length of stay (ICU LOS), hospital length of stay (hospital LOS), and site of COVID-19 test. Additional demographic data collected included age, gender, pregnancy status, nationality, and healthcare worker status. Patients were categorized based on their primary reason for admission as either medical, scheduled/elective surgery, or emergency surgery. Descriptive statistics and bivariate analyses using crosstabs, ANOVA, and t-tests were conducted to compare outcomes between admission groups. A p-value of <0.05 was considered statistically significant.
Results: The mean ICU LOS was 72.43 days and mean hospital LOS was 20.66 days. Most patients were admitted for medical reasons (55.6%), followed by emergency surgery (26.5%) and scheduled/elective surgery (17.9%). ICU LOS was not significantly different between admission groups based on one-way ANOVA (F=0.208, p=1.000) or post-hoc testing. However, hospital LOS was significantly different (F=3.951, p<0.001), with the emergency surgery group having a longer mean LOS (24.96 days) than the medical (19.99 days) or scheduled/elective surgery groups (16.81 days). Bivariate analyses also found several demographic variables like age, gender, and healthcare worker status had significant associations with hospital LOS but not ICU LOS.
Conclusion: This study found that while primary reason for ICU admission did not significantly impact ICU LOS, it did influence overall hospital LOS. Patients admitted after emergency surgery experienced significantly longer hospitalizations compared to other admission groups. Demographic factors also played a role in determining length of hospital stay. Further research is needed to understand how clinical characteristics and care processes influence outcomes for different types of critically ill patients. This may help optimize resource use and inform strategies to reduce hospital LOS, especially for emergency surgery patients.