Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

Abstract

Background: The burden of life-threatening conditions requiring intensive care unit has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality is varied from region to region in Ethiopia. However, 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 institutional Review Board (IRB), a multi-center retrospective Cohort study was conducted among three teaching referral hospital ICUs of southern 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 determine 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 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.

Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia

“…Mechanically ventilated patients have a very high mortality rate in our ICU, which is comparable with data from other low- and middle-income countries [ 9 , 13 , 18 ]. A low Glasgow Coma Scale, a cardiovascular diagnosis, and a very low serum albumin level were independent predictors of death in multivariable logistic regression.…”

“…In addition, there are no respiratory therapists in the medical and surgical ICUs. Mechanical ventilators are managed by clinicians with limited training [ 18 ], potentially affecting patient outcomes. Second, similar to other studies [ 5 , 13 , 18 ], we found that patients with low GCS were more likely to die.…”

“…Mechanical ventilators are managed by clinicians with limited training [ 18 ], potentially affecting patient outcomes. Second, similar to other studies [ 5 , 13 , 18 ], we found that patients with low GCS were more likely to die. The change in mental status may represent an indicator of severe illness or a primary neurological disease.…”