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埃塞俄比亚南部重症监护病房患者的生存情况及死亡预测因素:一项多中心队列研究。

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

作者信息

Abate Semagn Mekonnen, Assen Sofia, Yinges Mengistu, Basu Bivash

机构信息

Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Ethiopia.

Departemnt of Anesthesiology, College of Health Sciences and Medicine, Hawassa University, Ethiopia.

出版信息

Ann Med Surg (Lond). 2021 Apr 17;65:102318. doi: 10.1016/j.amsu.2021.102318. eCollection 2021 May.

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.

摘要

背景

在低收入国家,由于新出现的大流行、城市化和医院扩张,需要重症监护病房的危及生命疾病的负担大幅增加。埃塞俄比亚各地区的重症监护病房死亡率各不相同。然而,关于重症监护病房死亡率及其预测因素的证据并不确定。本研究旨在调查埃塞俄比亚南部的疾病模式和死亡率预测因素。

方法

在获得机构审查委员会(IRB)的伦理批准后,于2018年6月至2020年5月在埃塞俄比亚的三家教学转诊医院重症监护病房进行了一项多中心队列研究。选取了517名成人重症监护病房患者。数据录入社会科学统计软件包第22版和STATA第16版进行分析。进行描述性统计以查看变量的总体分布。采用卡方检验和比值比来确定自变量和因变量之间的关联。进行多变量分析以控制可能的混杂因素并确定重症监护病房死亡率的独立预测因素。

结果

入住重症监护病房患者的平均(±标准差)年龄为34.25(±5.25)岁。总体重症监护病房死亡率为46.8%。该研究确定了不同的死亡率独立预测因素。心脏骤停患者死亡的可能性是未发生心脏骤停患者的约12倍,调整后比值比=11.9(95%置信区间:6.1至23.2)。

结论

与埃塞俄比亚以及全球的其他研究相比,重症监护病房的总体死亡率非常高,这需要不同利益相关者开展严格的行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4ac/8091884/4e22e26b6595/gr1.jpg

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