Factors Associated with Patient who Underwent Leave Against Medical Advice in the Semi-closed Intensive Care Unit

Abstract

Background: Leave against medical advice is a more prevalent challenge in Intensive Care units of developing countries compared to developed ones.
Methods: This prospective observational study was done included 466 patients aged ?18 years who underwent leave against medical advice in a level three intensive care unit of a medical college. The patient admitted to the intensive care unit who chose to leave against the clinicians’ advice was referred to as leaving against medical advice. All data were first entered into an Excel sheet and then transferred to a statistical package for the social sciences-16 for analysis. The descriptive data are presented as the number and percentage for categorical data and mean ± standard deviation for continuous data according to their distribution.
Results: A total of 466 patients were included in the study, and among them,273(58.58%) were male and 193(41.41%) were female. Middle- aged patients account for 234(50.21%) cases. Most patients, 460(98.71%) were admitted from the emergency department. LAMA occurred most frequently during morning shift, 258(55.56%) and in the month of Chaitra 19.4%.The mean ICU stay was 2.53±1.92 days. Internal Medicine accounted for 221(47.2%) who underwent leave against medical advice. 59(12.6%) were mechanically ventilated. Poor prognosis was the primary reason in 278(59.64%) patients who underwent leave against medical advice.
Conclusions: Poor prognosis and financial problems were the most common reasons for patients to leave against medical advice. Therefore, government and other institutions should address this as a critical issue in patient management.
Keywords: Developing country; Intensive Care Units; Morbidity