Outcome of patients in level II intensive care unit in a rural referral center: a cross-sectional study

Abstract

Introduction: Intermediate intensive care units (ICUs) in province-level hospitals in Nepal offer continuous monitoring, inotropic support, and non-mechanical ventilation.  Only some of these ICU settings in rural Nepal are functional. These ICUs improve patient outcomes, manage patients until their transfer to advanced ICUs, andreduce unnecessary referrals in terminal illnesses. There were few studies on the performance ofurban and advanced-level 3 ICUs in Nepal. These studies were essential for comparing the quality and efficiency of ICUs. The study aimed to describe the admissions and their outcomes in a level 2 ICU in rural Nepal.

Method: A cross-sectional descriptive study was conducted at Chaurjahari Hospital in Rukum West from July 2024 to June 2025. Patient characteristics, primary diagnosis, length of stay, and outcomes were recorded.

Result: Total number of patients admitted to ICU was 71(0.07%). The numbers of male and female patients were 23 (32.4%) and 48 (67.6%), respectively. Median age was 62 years. Most patients were admitted from the emergency department, which was 61(86%). COPD was most common diagnosis. The medianlengthof stay was four days. The recovery rate was 63.4% with a referral rate of 14.1%.

Conclusion: Less than one percent of hospital patients required intensive care, with a predominance of female and elderly patients. Most of the patients in the rural ICU came from the emergency department with acute exacerbation of COPD as the most common diagnosis. The length of stay and recovery rate were comparable to those in other ICU settings in the country.