Outcomes in Critical Care Delivery at Jimma University Specialised Hospital, Ethiopia

Abstract

Outcomes in critical care delivery at SUMMARY The aim of this study was to assess outcomes following intensive care unit (ICU) admissions at Jimma University Specialised Hospital, Ethiopia. This was a retrospective observational study. Data were collected regarding all ICU admissions and discharges during a 12-month period beginning August 2011. Demographic data and information regarding diagnosis, length-of-stay and outcome were gathered and data analysed. There were 370 admissions to the ICU during the study period. Median age (interquartile range) was 32.0 (22.0-47.0) years and 56.2% were males. The median length-of-stay (interquartile range) was 3.0 (1.0-7.0) days. The overall ICU mortality rate was 50.4% and major causes included trauma, cardiac disease, acute abdominal presentations, septic shock, tetanus and hysterectomy secondary to uterine rupture. Medical diagnoses accounted for 50.1% of admissions followed by surgery (43.2%) and obstetrics (5.8%). Corresponding mortality rates were 53.6, 48.0 and 42.9%, respectively. The main cause for surgical admission was trauma, with head injury carrying a mortality of 52.1%. The principal cause for medical admission was cardiac disease. In children, trauma, upper airway obstruction and communicable diseases were most common. Critical care mortality rates at this Ethiopian university hospital reflect the challenges facing critical care delivery in the developing world. Delayed presentation to hospital secondary to poor access to healthcare plays a predominant role. This is confounded by inadequate staffing, training, diagnostic and interventional limitations. Despite resource restraints, simple cost-effective measures may improve morbidity and mortality.

Admission pattern, Clinical outcome and associated factors among patients admitted in medical intensive care unit at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia, 2019. A retrospective cross-sectional study.

“…In this study, the overall mortality rate in ICU found to be 38.7 %( 95% CI: 34.5, 43.1). This finding is comparable with studies done in Addis Ababa (39%) and Jimma (37.7%) (10,11). It also similar to the studies conducted in Nigeria (34.6%), Uganda (40.1%) and Tanzania (41.1%) (13,15,16).…”

“…In Ethiopia, different studies showed that the mortality rate is relatively similar to other Africa countries. Studies done in Jimma, Addis Ababa, and Mekelle showed that the mortality rate was 50.4%, 32% and 27% respectively (10)(11)(12).…”

The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital

“…The overall mortality found by this study was 40%, which has also been reported in previous studies conducted in the same setting, but addressing adults. 12 , 13 The outcome is also the same when it comes to the pediatrics population. This might be due to inadequate staffing, experience, and resources as in any other sub-Saharan African countries.…”

“…Previous investigations at Jimma University Specialized Hospital (JUSH) have generally addressed admissions and outcomes covering all ages in the general intensive care unit (GICU), but none have paid particular attention to the pediatric age group. Two previous studies in this intensive care unit had reported that the overall intensive care unit mortality rate was high (50.4% 12 and 37.7% 13 ).…”

“…This might be due to inadequate staffing, experience, and resources as in any other sub-Saharan African countries. 12 , 25 , 29 …”