Factors influencing length of stay in intensive care unit at a selected referral hospital in Rwanda.

Abstract

Introduction: Length of stay (LOS) in the intensive care unit (ICU) is one of the most important factors that influence patient outcome and vary depending on severity of illness, the use of invasive medical devices, nutritional status and comorbidities. ICU length of stay is one impact of patient complications and high cost of health care on both family and hospital. Objective: The study aimed to assess factors that influence patient length of stay in intensive care unit at the University Teaching Hospital of Kigali. Method: Non-experimental retrospective descriptive design and quantitative approach were used. The study was conducted at the University Teaching Hospital of Kigali in intensive care unit on 176 out of 315 files of patients admitted in ICU from January to December 2018 were selected using systematic sampling method. A self-developed structured checklist on “factors influencing length of stay in intensive care unit” was used for data collection. Results: Among 176 reviewed patients „files, the average of length of stay was 24 days with the mean of length of stay 10.02 with standard deviation 13.068. The majority of patients did not have prolonged stay 159(90.9%) and only 16(9.1%) had prolonged stay. Post cesarean peritonitis and AKI , tracheoesophagial fistula and lung contusion, UTI post severe malaria, diffused axonal injury blunt chest trauma and blunt abdominal injury were associated with prolonged stay P<0.05 and a Multinomial logistic regression shows that intubation with mechanical ventilation, reintubation and unplanned extubation are more likely to cause prolonged stay ODDs ratio>1. Conclusion: Patients who stayed over 24 days in ICU had prolonged stay. Physicians and nurses should carefully take care of ICU patients to avoid prolonged stay.