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在埃塞俄比亚西北部阿姆哈拉州,成人患者入住重症监护病房的死亡率及其预测因素的研究。

The magnitude of mortality and its predictors among adult patients admitted to the Intensive care unit in Amhara Regional State, Northwest Ethiopia.

机构信息

Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar Town, Ethiopia.

Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia.

出版信息

Sci Rep. 2023 Jul 25;13(1):12010. doi: 10.1038/s41598-023-39190-7.

Abstract

Despite mortality in intensive care units (ICU) being a global public health problem, it is higher in developing countries, including Ethiopia. However, insufficient evidence is established concerning mortality in the ICU and its predictors. This study aimed to assess the magnitude of ICU mortality and its predictors among patients at Tibebe Ghion specialized hospital, Northwest Ethiopia, 2021. A retrospective cross-sectional study was conducted from February 24th, 2019, to January 24th, 2021. Data were collected from medical records by using pretested structured data retrieval checklist. The collected data was entered into Epi-data version 3.1 and analyzed using R version 4.0 software. Descriptive statistics computed. A simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality. A total of 568 study participants' charts were reviewed. The median length of ICU stay was four days. Head trauma and shock were the leading causes of ICU admissions and mortality. The overall mortality rate of the ICU-admitted patients was 29.6% (95% CI: 26%, 33%). Admission in 2020 (AOR = 0.51; 95%CI: 0.31, 0.85), having altered mentation (AOR = 13.44; 95%CI: 5.77, 31.27), mechanical ventilation required at admission (AOR = 4.11; 95%CI: 2.63, 6.43), and stayed < 5 days in the ICU (AOR = 3.74; 95%CI: 2.31, 6.06) were significantly associated with ICU mortality. The magnitude of the ICU mortality rate was moderate. Years of admission, altered mentation, mechanical ventilation required at admission, and days of stay in the ICU were the predictors for ICU mortality. This finding underscores the importance of interventions to reduce ICU mortality.

摘要

尽管重症监护病房(ICU)的死亡率是一个全球性的公共卫生问题,但在发展中国家,包括埃塞俄比亚,这个问题更为严重。然而,关于 ICU 死亡率及其预测因素的证据还不够充分。本研究旨在评估 2021 年在埃塞俄比亚西北部的提贝比格翁专科医院 ICU 患者的死亡率及其预测因素。这是一项回顾性的横断面研究,从 2019 年 2 月 24 日至 2021 年 1 月 24 日进行。数据通过使用预测试的结构化数据检索清单从病历中收集。收集的数据输入 Epi-data 版本 3.1,并使用 R 版本 4.0 软件进行分析。计算描述性统计数据。进行了简单的逻辑分析(95%置信区间和 p 值<0.05),以确定 ICU 死亡率的决定因素。共回顾了 568 名研究参与者的图表。ICU 住院时间的中位数为四天。头部创伤和休克是 ICU 入院和死亡的主要原因。ICU 入院患者的总体死亡率为 29.6%(95%CI:26%,33%)。2020 年入院(AOR=0.51;95%CI:0.31,0.85)、意识改变(AOR=13.44;95%CI:5.77,31.27)、入院时需要机械通气(AOR=4.11;95%CI:2.63,6.43)和 ICU 住院时间<5 天(AOR=3.74;95%CI:2.31,6.06)与 ICU 死亡率显著相关。ICU 死亡率的幅度为中度。入院年份、意识改变、入院时需要机械通气和 ICU 住院天数是 ICU 死亡率的预测因素。这一发现强调了采取干预措施降低 ICU 死亡率的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2be3/10368686/4f45a037bf69/41598_2023_39190_Fig1_HTML.jpg

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