Browsing by Author "Bolaji, Olusomi"

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    The high dependency unit in the management of critically Ill obstetric patients in low resource countries
    (university of Sierra Leone, Freetown, Sierra Leone, 2015-12) Adeniran, Abiodun; Bolaji, Olusomi; Fawole, Adegboyega; Oyedepo, Olanrewaju; Gbadeyan O, Ejilude O
    The care of the obstetric population requiring critical care at the intensive care unit is associated with challenges that have made the establishment of obstetric high dependency units (HDU) a priority in the developed unlike low resource countries. The objective was to evaluate the need to establish obstetric HDUs in low resource countries. The study was a retrospective descriptive study of obstetric patients admitted into the intensive care unit of the University of Ilorin Teaching Hospital from 1st January 2010 to30th June 2013. Those that were suitable for management at a HDU were compared with those who needed ICU care. The statistical analysis was with SPSS version 20 with p-values, x2 and odds ratio; p value <0.05 was considered significant. All the 52 patients were postpartum; 16(30.8%) were suitable for HDU care. Of the HDU eligible patients, 11(68.8%) were of low social class, 12(75%) were booked, 11(68.8%) had no further complication at ICU and mortality was 1(6.25%). Compared to those who needed ICU care, there were no statistical significance in maternal age, parity, duration of ICU admission and total cost of ICU care. There were more cases with statistical significance of organ involvement (p<0.001), severity of Glasgow coma score at admission (p<0.001), further complications at ICU (p<0.001) and maternal mortality (p<0.001) among those needing ICU care compared to those needing HDU care. In conclusion, establishment of the HDU will reduce cost and the burden on the few ICUs in low resource countries without increasing maternal mortality
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    Predictors ofmaternalmortality among critically Ill obstetric patients
    (University of Malawi and Malawi Medical Association, 2015-03) Adeniran, Abiodun; Bolaji, Olusomi; Fawole, Adegboyega; Oyedepo, Olanrewaju
    Aim Evaluation of the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU). Methods A case control study to evaluate the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria from 1st January 2010 to 30th June 2013. Participants were critically ill obstetric patients who were admitted and managed at the ICU during the study period. Subjects were those who died while controls were age and parity matched survivors. Statistical analysis was with SPSS-20 to determine chi square, Cox-regression and odds ratio; p value < 0.05 was significant. Results The mean age of subjects and controls were 28.92 ± 5.09 versus 29.44 ± 5.74 (p = 0.736), the level of education was higher among controls (p= 0.048) while more subjects were of low social class (p = 0.321), did not have antenatal care (p = 0.131) and had partners with lower level of education (p = 0.156) compared to controls. The two leading indications for admission among subjects and controls were massive postpartum haemorrhage and severe preeclampsia or eclampsia. The mean duration of admission was higher among controls (3.32 ± 2.46 versus 3.00 ± 2.58; p = 0.656) while the mean cost of ICU care was higher among the subjects (p = 0.472). The statistical significant predictors of maternal deaths were the patient’s level of education, Glasgow Coma Scale (GCS) score, oxygensaturation, multiple organ failure at ICU admission and the need for mechanical ventilation or inotrophic drugs after admission. Conclusion The clinical state at ICU admission of the critically ill obstetric patients is the major outcome determinant. Therefore, early recognition of the need for ICU care, adequate pre-ICU admission supportive care and prompt transfer will improve the outcome.