Pattern of diseases and clinical outcomes in medical intensive care unit at a tertiary hospital in northeastern Tanzania: A three-year retrospective study

Abstract

Background The availability of medical intensive care unit (MICU) services is limited, which is the main obstacle to providing optimal care to critically ill patients. Describing disease patterns and clinical outcomes will help make better use of the limited resources. This retrospective study was conducted to determine the pattern and outcome of MICU admissions to aid continuous quality improvement in obstetric care. Materials and methods This was a retrospective study conducted in a tertiary hospital in northeastern Tanzania. Data on participant characteristics were collected from patient records for all MICU admissions to identify the pattern of disease, length of stay, and clinical outcome from 1st January 2018 to 31st December 2020. Descriptive statistics were presented as frequencies, proportions, and tables. The odds ratio was generated for the relationship between MICU admission outcome and participant characteristics. A p-value <0.05 was considered statistically significant. Results Of the 1425 patients analyzed, 780 (54.7%) were males. Most patients (61.5%) were admitted to the MICU from the emergency department. The overall mortality rate was 37.6%. Mortality was associated with being over 75 years old (OR 1.66, 95% CI 1.20–2.30, P 0.002), being transferred from the medical ward (OR 1.46, 95% CI 1.16–1.82, P 0.001), having a communicable disease (OR 2.63, 95% CI 1.98–3.50, P <0.001), and having cardiovascular disease (OR 1.46, 95% CI 1.14–1.86, P 0.002). Conclusion The overall mortality rate in the MICU was high. Elderly patients, transfers from the medical ward, and short ICU stays were significantly associated with the poor outcome of MICU patients. Further studies are needed to better appreciate the causes underlying MICU admission outcomes.

The Pattern of Admission, Clinical Characteristics, and Outcomes Among Patients Admitted to the Intensive Care Unit of a Tertiary Hospital in Tanzania: A 5-Year Retrospective Review

“…Previous findings from the Aga Khan Hospital Dar-es-salaam that looked into the performance of predictive scoring models reported similar findings. 4 Our study results depict a very low ICU mortality rate when compared to similar studies done in Tanzania 2 , 3 and other countries in Sub-Saharan Africa. 5–9 , 16–18 The discrepancy can be chiefly attributed to the level of care that the hospital provides, which is comparable in various ways to facilities in High-Income Countries (HICs).…”

“… 35 The in-ICU mortality rate among patients with septic shock at our center was approximately 30%, in line with global 31 and previously conducted studies at our center 4 but much lower when compared to studies done in other parts of Africa. 2 , 3 , 6 , 36 , 37 The infectious disease section of the hospital has made great efforts in setting up a well-equipped laboratory and a comprehensive antibiotic stewardship program able to deliver time-sensitive results and combat antimicrobial resistance. Nonetheless, this is insufficient and might not be applicable in the public sector due to resource limitations.…”

Disease pattern and mortality rate among patients admitted to the Intensive Care Unit in Arbaminch General Hospital, Southern Ethiopia

“…In the United States, it ranges from 9.3-18.7% which is signi cantly lower than that reported for other developing countries (5). The overall intensive care mortality rate in Japan is higher than USA (1,5). The mortality rates in Nigeria, Tanzania, Egypt, Sudan, and Ethiopia are 3 to 7 times higher than those in developed countries.…”

“…This is probably due to less quali ed human power, poorly functioning hospital systems, and inadequate equipment. The mortality rate is associated with different factors in different setups, such as length on mechanical ventilator, complications developed, increased hospital stay, concomitant comorbidity, and level of consciousness on admission (3)(4)(5)(7)(8)(9)(10)(11). At our hospital, the disease patterns and mortality rates among intensive care unit admitted patients are unknown.…”

“…Abate et al reported that acute respiratory distress syndrome is the most frequent admission diagnosis, and the second most common cause of intensive care unit admission is post-operative complications (4). One report from Tanzania, showed esophageal varices followed by diabetic keto acidosis (5). To address speci c disease patterns in Intensive Care Unit, it is important to understand the distribution of diagnostic patterns in speci c hospitals (1)(2)(3)(4)(5)(6).…”