Time to recovery and its predictors among critically ill patients on mechanical ventilation from intensive care unit in Ethiopia: a retrospective follow up study

Abstract

Introduction For critically ill patients, mechanical ventilation is considered a pillar of respiratory life support. The mortality of victims in intensive care units is high in resource-constrained Sub-Saharan African countries. The recovery and prognosis of mechanically ventilated victims are unknown, according to evidence. The goal of the study was to see how long critically ill patients on mechanical ventilation survived. Methods A retrospective follow-up study was conducted. A total of 376 study medical charts were reviewed. Data was collected through reviewing medical charts. Data was entered into Epi-data manager version 4.6.0.4 and analyzed through Stata version 16. Descriptive analysis was performed. Kaplan- Meier survival estimates and log rank tests were performed. Cox proportional hazard model was undertaken. Results Median recovery time was 15 days (IQR: 6–30) with a total recovery rate of 4.49 per 100 person-days. In cox proportional hazard regression, diagnosis category {AHR: 1.690, 95% CI: (1.150- 2.485)}, oxygen saturation {AHR: 1.600, 95% CI: (1.157- 2.211)}, presence of comorbidities {AHR: 1.774, 95% CI: (1.250–2.519)}, Glasgow coma scale {AHR: 2.451, 95% CI: (1.483- 4.051)}, and use of tracheostomy {AHR: 0.276, 95% CI: (0.180–0.422)} were statistically significant predictors. Discussion Based on the outcomes of this study, discussions with suggested possible reasons and its implications were provided. Conclusion and Recommendations Duration and recovery rate of patients on mechanical ventilation is less than expected of world health organization standard. Diagnosis category, oxygen saturation, comorbidities, Glasgow coma scale and use of tracheostomy were statistically significant predictors. Mechanical ventilation durations should be adjusted for chronic comorbidities, trauma, and use of tracheostomy.

Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022

“…The present study found that the overall IDR of recovery was 6.53 per 100-day observation at a 95% CI (5.67-7.50). This finding is higher than the study conducted among mechanically ventilated patients in the ICU in Dessie, Ethiopia, which found a recovery rate of 4.49 per 100 person-days with a median recovery time of 15 days (8). The possible explanation for this discrepancy may be related to the difference in the study population between our study and the Dessie study, which included both traumatic and non-traumatic patients who were mechanically ventilated in the ICU.…”

“…This study found that the median recovery time of the study participants during the follow-up period was 10 days with a 95% CI (8)(9)(10)(11) and an overall recovery rate of 49.9% at a 95% CI (45.0-54.8). This result is consistent with the study conducted in South Africa, which reported that the median time to recover was 10 days (23).…”

“…Using STATA software version 14.1 and the stpower Cox model, the sample size was estimated for the survival analysis through power and sample size estimates. The calculation was performed based on the assumptions of a type I error of 5%, power of 80%, a standard deviation of 0.5, a probability withdrawal of 10%, the overall probability of an event of 0.472 according to the study conducted in Jimma, Ethiopia ( 15 ), and the crude hazard ratio (CHR) of GCS 1.5 ( 8 ), which is the most common predictor of recovery in most literature. Finally, the total sample size was 450.…”

“…During the follow-up period, of the total of 403 trauma patients admitted to the ICU, 201 were recovered, making the overall incidence density rate (IDR) of recovery 6.53 per 100-day observation at a 95% CI (5.67-7.50). The median recovery time was 10 days, with a 95% CI (8)(9)(10)(11). The total follow-up time of this cohort was 3,076 days, with a median follow-up time of 4 days (IQR of 2-10 days).…”

Impact of Ventilator-Associated Pneumonia Preventative Measures and Ventilator Bundle Care in a Tertiary Care Hospital’s Adult Intensive Care Unit

“…VAP is seen in a range of 9% to 24% of patients who have intubation for a duration beyond 48 hours [3]. This condition is linked to substantial morbidity and death rates, and it also results in a notable escalation in the utilization of resources [4,5]. The determination of whether a patient requires MV is contingent upon several factors, including the presence of comorbidities, the clinical condition of the patient, and the duration of MV [6,7].…”