Survival and predictors of mortality among patients admitted to the intensive care units in southern Ethiopia: A multi-center cohort study

Abstract

Background The burden of life-threatening conditions requiring intensive care units has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality varied from region to region in Ethiopia. However, the body of evidence on ICU mortality and its predictors is uncertain. This study was designed to investigate the pattern of disease and predictors of mortality in Southern Ethiopia. Methods After obtaining ethical clearance from the Institutional Review Board (IRB), a multi-center cohort study was conducted among three teaching referral hospital ICUs in Ethiopia from June 2018 to May 2020. Five hundred and seventeen Adult ICU patients were selected. Data were entered in Statistical Package for Social Sciences version 22 and STATA version 16 for analysis. Descriptive statistics were run to see the overall distribution of the variables. Chi-square test and odds ratio were determined to identify the association between independent and dependent variables. Multivariate analysis was conducted to control possible confounders and identify independent predictors of ICU mortality. Results The mean (±SD) of the patients admitted in ICU was 34.25(±5.25). The overall ICU mortality rate was 46.8%. The study identified different independent predictors of mortality. Patients with cardiac arrest were approximately 12 times more likely to die as compared to those who didn't, AOR = 11.9(95% CI:6.1 to 23.2). Conclusion The overall mortality rate in ICU was very high as compared to other studies in Ethiopia as well as globally which entails a rigorous activity from different stakeholders.

Admission and Mortality Patterns in Intensive Care Delivery at Enugu State University of Science and Technology Teaching Hospital: A Three-Year Retrospective Study

“…This agrees with a multi-center cohort study, which noted that patients who sustained cardiac arrest were approximately 12 times more likely to die as compared to those who did not. This may be due to a lack of facilities for resuscitation, as well as trained staff in advanced cardiac life support (ACLS) [ 21 ].…”

Intensive Care in Sub-Saharan Africa: A National Review of the Service Status in Ethiopia

“…Although childbirth and infectious diseases remain the primary causes of mortality, emergency care and surgical burden, notably related to road traffic collisions are rising. 3 , 4 To address the significant surgical burden, improvements in surgical access have been addressed through national programs, with a 10-fold increase in the number of surgeries per 100,000 people from 2012 to 2019. 5 An accompanying expansion of critical care services has not been demonstrated and there remains a paucity of data pertaining to the provision of critical care in Ethiopia, as in many low- and middle-income countries (LMICs).…”

The magnitude of mortality and its determinants in Ethiopian adult intensive care units: A systematic review and meta-analysis

“…Studies included were conducted in Ethiopia and published in journals that are indexed. Based on the region, three studies were conducted in Addis Ababa [ 34 , 38 , 40 ], three studies in Amhara [ 37 , 44 , 46 ], four studies in Oromia [ 11 , 36 , 42 , 45 ],.two studies in Southern Nations, Nationalities, and Peoples (SNNP) [ 35 , 41 ], and two studies in Tigray [ 39 , 43 ]. Seven studies were cross-sectional, four studies were cohort (retrospective and prospective), two studies were longitudinal, and one study was prospective observational.…”

“…Ethiopia had 114 million people and 51 intensive care units with only 324 intensive care unit beds, resulting in a national ICU bed-to-population ratio of 0.3 per 100,000 people [ 33 ]. According to various studies conducted in Ethiopia, the mortality rate following ICU admission was high, ranging between 18.3 and 67.4% [ 11 , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ]. Among factors related to the resources of a hospital that contribute to the mortality of patients in ICU include training and skills of medical staff, nurse-to-patient ratio, infrastructure, and shortage of essential drugs and equipment [ 47 ].…”

“…Among factors related to the resources of a hospital that contribute to the mortality of patients in ICU include training and skills of medical staff, nurse-to-patient ratio, infrastructure, and shortage of essential drugs and equipment [ 47 ]. Age, Duration of ICU stay, presence of comorbidities, complications at ICU, traumatic injury, sepsis, need for mechanical ventilation, need for vasopressors/inotrope, and low GCS score as potential factors affecting the survival of patients in ICU [ 34 , 35 , 40 , 41 , 46 ].…”