Incidence and predictors of mortality among adult trauma patients admitted to the intensive care units of comprehensive specialized hospitals in Northwest Ethiopia

Abstract

Background Trauma is the leading cause of morbidity and mortality among adult population in the world. Despite many improvements in technology and care, mortality among trauma patients in the intensive care unit is still high particularly in Ethiopia. However, there is limited evidence on the incidence and predictors of mortality among trauma patients in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of mortality among adult trauma patients admitted to intensive care units. Methods Institutional-based retrospective follow-up study was conducted from January 9, 2019 to January 8, 2022. A total of 421 samples were chosen using simple random sampling. Data were collected with Kobo toolbox software and exported to STATA version 14.1 software for data analysis. Kaplan–Meier failure curve and log-rank test were fitted to explore the survival difference among groups. After the bivariable and multivariable Cox regression analysis, an Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CI) was reported to declare the strength of association and statistical significance, respectively. Result The overall incidence rate of mortality was 5.47 per 100 person-day observation with a median survival time of 14 days. Did not get pre-hospital care (AHR = 2.00, 95%CI 1.13, 3.53), Glasgow Coma Scale (GCS) score < 9 (AHR = 3.89, 95%CI 1.67, 9.06), presence of complications (AHR = 3.71, 95%CI 1.29, 10.64), hypothermia at admission (AHR = 2.11, 95%CI 1.13, 3.93) and hypotension at admission (AHR = 1.93, 95%CI 1.01, 3.66) were found significant predictors of mortality among trauma patients. Conclusion The incidence rate of mortality among trauma patients in the ICU was high. Did not get pre-hospital care, GCS < 9, presence of complications, hypothermia, and hypotension at admission were significant predictors of mortality. Therefore, healthcare providers should give special attention to trauma patients with low GCS scores, complications, hypotension, and hypothermia and better to strengthen pre-hospital services to reduce the incidence of mortality.

Development and validation of a nomogram for predicting in-hospital mortality in patients with nonhip femoral fractures

“…In the management of trauma patients, body temperature is an important vital sign. Numerous studies have shown that lower body temperature at admission is associated with increased in-hospital mortality in critically ill trauma patients [11][12][13]. In this study, the body temperature of patients in the nonsurvival group was lower than that in the survival group.…”

Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022

“…There have been numerous initiatives over the past few years to decrease the amount of time it takes trauma victims to recover, including the development of trauma centers, the use of diagnostic tools, and training for human resources ( 11 , 12 ). The Ethiopian government has also been working to lessen the terrible consequences of trauma ( 13 ). In order to reduce the mortality rate from all types of injuries, expand and strengthen basic and advanced critical care services, and strengthen trauma units in healthcare facilities, Ethiopia’s Federal Ministry of Health (FMOH) has launched a 5-year strategic plan (Health Sector Transformation Plan II) ( 12 ).…”