Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Eur J Med Res. 2023 Mar 9;28(1):113. doi: 10.1186/s40001-023-01056-z.
Trauma is the leading cause of morbidity and mortality among adult population in the world. Despite many improvements in technology and care, mortality among trauma patients in the intensive care unit is still high particularly in Ethiopia. However, there is limited evidence on the incidence and predictors of mortality among trauma patients in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of mortality among adult trauma patients admitted to intensive care units.
Institutional-based retrospective follow-up study was conducted from January 9, 2019 to January 8, 2022. A total of 421 samples were chosen using simple random sampling. Data were collected with Kobo toolbox software and exported to STATA version 14.1 software for data analysis. Kaplan-Meier failure curve and log-rank test were fitted to explore the survival difference among groups. After the bivariable and multivariable Cox regression analysis, an Adjusted Hazard Ratio (AHR) with 95% Confidence Intervals (CI) was reported to declare the strength of association and statistical significance, respectively.
The overall incidence rate of mortality was 5.47 per 100 person-day observation with a median survival time of 14 days. Did not get pre-hospital care (AHR = 2.00, 95%CI 1.13, 3.53), Glasgow Coma Scale (GCS) score < 9 (AHR = 3.89, 95%CI 1.67, 9.06), presence of complications (AHR = 3.71, 95%CI 1.29, 10.64), hypothermia at admission (AHR = 2.11, 95%CI 1.13, 3.93) and hypotension at admission (AHR = 1.93, 95%CI 1.01, 3.66) were found significant predictors of mortality among trauma patients.
The incidence rate of mortality among trauma patients in the ICU was high. Did not get pre-hospital care, GCS < 9, presence of complications, hypothermia, and hypotension at admission were significant predictors of mortality. Therefore, healthcare providers should give special attention to trauma patients with low GCS scores, complications, hypotension, and hypothermia and better to strengthen pre-hospital services to reduce the incidence of mortality.
创伤是世界上成年人发病率和死亡率的主要原因。尽管技术和护理方面有了许多进步，但重症监护室创伤患者的死亡率仍然很高，尤其是在埃塞俄比亚。然而，关于埃塞俄比亚创伤患者的死亡率发生率和预测因素的证据有限。因此，本研究旨在评估重症监护病房成年创伤患者的死亡率发生率和预测因素。
本研究是一项基于机构的回顾性随访研究，于 2019 年 1 月 9 日至 2022 年 1 月 8 日进行。采用简单随机抽样法选择了 421 例样本。使用 Kobo 工具包软件收集数据，并将其导出到 STATA 版本 14.1 软件进行数据分析。采用 Kaplan-Meier 失败曲线和对数秩检验来探索组间的生存差异。在进行两变量和多变量 Cox 回归分析后，报告调整后的风险比（AHR）及其 95%置信区间（CI），以分别表示关联强度和统计学意义。
总的死亡率发生率为每 100 人日观察 5.47 例，中位生存时间为 14 天。未接受院前护理（AHR=2.00，95%CI 1.13，3.53）、格拉斯哥昏迷评分（GCS）评分<9（AHR=3.89，95%CI 1.67，9.06）、存在并发症（AHR=3.71，95%CI 1.29，10.64）、入院时体温过低（AHR=2.11，95%CI 1.13，3.93）和入院时低血压（AHR=1.93，95%CI 1.01，3.66）是创伤患者死亡的显著预测因素。
重症监护室创伤患者的死亡率发生率较高。未接受院前护理、GCS<9、存在并发症、入院时体温过低和低血压是死亡的显著预测因素。因此，医疗保健提供者应特别关注 GCS 评分低、有并发症、低血压和低体温的创伤患者，并加强院前服务，以降低死亡率。
