Browsing by Author "Pathak, Sunil"
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Publication A Seven-Year Audit of Intensive Care Unit Admissions and Outcome in a Tertiary Care Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2025) Sharma, Sachit; Shrestha, Gentle Sunder; Shrestha, Pramesh Sundar; Paneru, Hem Raj; Pathak, Sunil; Rijal, Divas; Acharya, Subhash PrasadAbstract: Introduction An audit is used to assess if a particular aspect of health care is in accordance with the standard practice and aims to achieve improvement in quality for the benefit of the patient. The current study is a retrospective descriptive observational audit which intends to study the patient profile and outcome of patients admitted to a level III ICU of a tertiary care hospital in Nepal over a duration of seven years. Methods A retrospective descriptive observational audit was conducted in the Tribhuvan University Teaching Hospital (TUTH) ICU from 1st Baisakh, 2074 to 31st Chaitra, 2080. Data on patient profile and outcome were recorded and statistical analysis was performed. Results A total of 6,233 patients were admitted, with 53.9% male patients over a duration of 7 years in TUTH ICU. Medical admissions accounted for 51.67% and surgical admissions 48.33%. Overall, the maximum number of cases were admitted under neurosurgical speciality. Of all patients, 64.7% improved and were shifted out of ICU while mortality was 27.4%. An average sequential organ failure assessment (SOFA) score was 6.7 during the study period. Conclusion The major finding of the study was a progressive decline in average SOFA score, average length of ICU stay and average length of Mechanical Ventilation over the last 3 years. The highest number of admission was in neurosurgery and respiratory medicine over the duration of seven years.Publication Admission Profile and Outcome of Patients in a Level III Intensive Care Unit: A Two-Year Comparative Study(Institute of Medicine, 2020) Pathak, Sunil; Acharya, Subhash P; Acharya, Pragya; Bhattarai, BinitaABSTRACT Introduction: An Intensive Care Unit (ICU) is an area where critically ill patients are admitted and the highest level of care is provided with close intensive monitoring and management. Clinical audit is a must to measure indicators of the quality of care in ICU and benchmarking outcome. The main aim of the study was to evaluate the profile of patients admitted to ICU and assess their outcome of two consecutive years. Methods:A single-institutional, descriptive cross-sectional study was conducted on all adult patients admitted to the ICU of Tribhuvan University Teaching Hospital, Kathmandu, between April 2018 and April 2020 (Baisakh 2075 to Chaitra 2076). Results: With an average of 1.98 admissions per day, a total of 1447 patients were admitted to TUTH ICU over the period of two years. A male preponderance was noted with a male to female ratio of 1.19:1. Most of the patients admitted were neurosurgical cases 429 (29.6%). A total of 884 (61%) were shifted out of ICU in stable condition while the overall mortality was 458 (31.6%). Conclusion:This study shows that there is a higher severity of illness at admission as well as a comparatively high mortality rate. More number of patients were male, of age group of 15-65 years, with medical and neurosurgical conditions. This study of profile and outcome of patients admitted in ICU can serve as a quality indicator as well as evidence on which planning and policymaking can be based upon in the future. Keywords: Intensive care unit, medical audit, outcome