The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A CrossSectional Study

Mbengono, Junette Arlette Metogo; Tochie, Joël Noutakdie; Ntock, Ferdinand Ndom; Nzoaungo, Yves Bertrand; Kona, S. Lakshmi Kumari; Ateba, Glwadys Ngono; Tocko, Cassandra; Colibaly, Aminata; Béyiha, G; Minkande, Jacqueline Zé

doi:10.15171/hpr.2019.24

Cited by 4 publications

(6 citation statements)

References 42 publications

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“…Patients with blood sodium levels above 150 mmol/L have a mortality rate between 30 and 48 percent, according to some studies carried out on the potential efects of hypernatremia on outcomes in critically sick patients in a medical ICU [26][27][28]. Relating to coma, a study carried out by Bekele et al in Ethiopia and Mbengono et al in Cameroon, reported that patients admitted with a Glasgow coma scale <9 were more likely to die [29,30]. Tis is understandable since a low GCS refects the severity of neurological impairment and reduced patient autonomy, making the patient more dependable and requiring closer monitoring [31].…”

Section: Discussionmentioning

confidence: 99%

In-ICU Outcomes of Critically Ill Patients in a Reference Cameroonian Intensive Care Unit: A Retrospective Cohort Study

Mandeng Ma Linwa,

Binam Bikoi,

Tochie Noutakdie

et al. 2023

Critical Care Research and Practice

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Introduction. Mortality rate amongst critically ill patients admitted to the intensive care unit (ICU) is disproportionately high in sub-Saharan African countries such as Cameroon. Identifying factors associated with higher in-ICU mortality guides more aggressive resuscitative measures to curb mortality, but the dearth of data on predictors of in-ICU mortality precludes this action. We aimed to determine predictors of in-ICU mortality in a major referral ICU in Cameroon. Methodology. This was a retrospective cohort study of all patients admitted to the ICU of Douala Laquintinie Hospital from 1st of March 2021 to 28th February 2022. We performed a multivariable analysis of sociodemographic, vital signs on admission, and other clinical and laboratory variables of patients discharged alive and dead from the ICU to control for confounding factors. Significance level was set at p < 0.05 . Results. Overall, the in-ICU mortality rate was 59.4% out of 662 ICU admissions. Factors independently associated with in-ICU mortality were deep coma (aOR = 0.48 (0.23–0.96), 95% CI, p = 0.043 ), and hypernatremia (>145 meq/L) (aOR = 0.39 (0.17–0.84) 95% CI, p = 0.022 ). Conclusion. The in-ICU mortality rate in this major referral Cameroonian ICU is high. Six in 10 patients admitted to the ICU die. Patients were more likely to die if admitted with deep coma and high sodium levels in the blood.

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Section: Discussionmentioning

confidence: 99%

In-ICU Outcomes of Critically Ill Patients in a Reference Cameroonian Intensive Care Unit: A Retrospective Cohort Study

Mandeng Ma Linwa,

Binam Bikoi,

Tochie Noutakdie

et al. 2023

Critical Care Research and Practice

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“…The percentage of different types of shock varies depending on the population served by the ED (4). Furthermore, shock, particularly septic shock, is reported to account for up to 9.4% of Intensive Care Unit (ICU) admission (5, 6).…”

Section: Introductionmentioning

confidence: 99%

“…It is also one of the major causes of mortality in the emergency room (1,7). Various studies conducted in different clinical settings around the world, including reviews, have shown that the rate of shock-related mortality ranges from 12% to 56.2%, depending on the type of shock (8)(9)(10)(11)(12)(13), the severity of shock (14)(15)(16), and the severity of underlying illness (15,17,18).…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Mortality and Predictors Among Patients with Shock Managed in the Emergency Room of a Large Tertiary Referral Hospital in Ethiopia

Asfaw,

Adugna,

Mekonen

et al. 2024

Preprint

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Background: Shock is a common emergency condition which can lead to organ failure and death if not diagnosed and managed timely. Despite its huge global impact, data is scarce in resource-limited settings, such as Ethiopia, which hinders the provision of quality care for improved patient outcomes. Hence, the aim of the study was to determine the incidence of death and predictors among adult patients with shock managed at the Emergency Department of St. Paul's Hospital Millennium Medical College in Ethiopia. Methods: A retrospective chart review study was conducted between July to September 2022 among 178 eligible adult patients who were managed at hospital between October 2021 and May 2022. The characteristics of the participants were summarized using frequency and median with interquartile range. The incidence of mortality was estimated using incidence density using person hour (PH) of observation. To identify predictors of mortality, a generalized linear model using poisson regression model with robust standard errors was run at 5% level of significance, where adjusted relative risk (ARR) with its 95% CI was used to interpret significant results Result: The incidence of death was 6.87 deaths per 1000 PH (95% CI= 5.44 to 8.69). Significant predictors of death were being triaged orange (ARR=0.46, 95% CI=0.24-0.88, p=0.020), having a high shock index (ARR=1.59, 95% CI=1.07-2.36, p=0.021), being diagnosed with septic shock (ARR=3.66, 95% CI=1.20-11.17, p=0.023), taking vasopressors (ARR=3.18, 95% CI=1.09, 9.27, p=0.034), and developing organ failure (ARR=1.79, 95% CI=1.04-3.07, p=0.035). Conclusion: The incidence of mortality among shock patients was found to be considerable but relatively lower than previous studies. To optimize patient care and improve outcomes, it is important to remain vigilant in the proper triage and early diagnosis of shock using more sensitive tools for prompt identification of high-risk cases, as well as to provide timely, prioritized and effective interventions.

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“…Other studies conducted in Europe, North America, China, and sub-Saharan Africa also demonstrated that patients admitted with a diagnosis of septic shock had a higher likelihood of ICU mortality compared to patients admitted with other diagnoses. [29][30][31] Patients with HIV comorbidity who were admitted to the ICU had an approximately 4.4 times higher risk of ICU mortality compared to patients without HIV comorbidity (AOR = 4.422765, 95% confidence interval: 1.3613-14.368). This strong association could be due to the fact that HIV infection is associated with an increased risk of severe infections, which in turn can contribute to higher ICU mortality rates.…”

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confidence: 99%

Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study

Melaku,

Urgie,

Dessie

et al. 2024

PROM

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Background The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit. Methods A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality. Results The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality. Conclusion and Recommendations This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.

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The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A CrossSectional Study

Cited by 4 publications

References 42 publications

In-ICU Outcomes of Critically Ill Patients in a Reference Cameroonian Intensive Care Unit: A Retrospective Cohort Study

In-ICU Outcomes of Critically Ill Patients in a Reference Cameroonian Intensive Care Unit: A Retrospective Cohort Study

Incidence of Mortality and Predictors Among Patients with Shock Managed in the Emergency Room of a Large Tertiary Referral Hospital in Ethiopia

Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study

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