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Critical care delivery in Ecuador: Current features and clinical outcomes

Abstract:

Objective To learn the current practice of critical care in Ecuador according to the organization, services rendered and clinical outcomes. Design Descriptive, prospective study of critical care units based on standard clinical critical care indicators. Setting Thirty one intensive care units and 23 hospitals in Ecuador. Patients All patients admitted during the first week of each month of 2014. Interventions None. Variables of interest Type of hospital and unit, organization, process of care and patients epidemiological profile. Results Data from 23 hospitals were collected; this included 31 intensive care units and 322 patients. 77.4% were mixed intensive care units, 87.1% were adult intensive care units, and 77.4% were multidisciplinary and closed intensive care units. The average nurse: patient ratio was 1:3.4 (SD = 1.6, median 3 [range 1-10]). 16% have an intensivist present 24 hours per day, 83.9% utilize management guidelines and protocols, and 45.2% have a check-list of objectives verification. The mean age was 51.9 years (SD = 2.3), 53.4% were male, 46.5% had respiratory illnesses, sepsis and trauma, and 26% were admitted for postoperative monitoring. Mean intensive care units length of stay was 6.5 days (SD = 7.1, median 4 [range 1-30]) and mortality rate was 21.7% (CI 95%, 17.6-26.6). Conclusions Organization and intensive care units care delivery in Ecuador, as well as clinical results obtained vary widely throughout the country, although comparable with the rest of countries in the region and worldwide.