Melaku Ermiyas Endewunet, Urgie Besufekad Mulugeta, Dessie Firmayie, Seid Ali, Abebe Zenebe, Tefera Aklile Semu
Department of Internal Medicine, School of Medicine, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Biostatistics, School of Public Health, Debre Berhan University, Debre Berhan, Ethiopia.
Patient Relat Outcome Meas. 2024 Feb 22;15:61-70. doi: 10.2147/PROM.S450502. eCollection 2024.
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.
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.
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.
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.
全球范围内重症监护服务正在不断发展。然而,在资源有限的环境中,其发展远远滞后,且由于各种原因,重症监护病房的死亡率仍然较高。本研究旨在评估入住重症监护病房的内科患者的死亡决定因素。
进行了一项为期五年的基于机构的回顾性队列研究。纳入了2017年3月至2022年2月期间入住重症监护病房的546名内科患者。采用结构化问卷进行文件审查以收集数据。录入Epi Data的数据由STATA进行分析,并使用频率表和图表进行总结。进行二元和多变量逻辑回归分析以确定死亡的决定因素。
总体死亡率为35.9%。约一半的死亡归因于感染性休克、充血性心力衰竭、重症社区获得性肺炎和中风。最常见的直接死亡原因是心肺骤停。发现入院来源、入院时的格拉斯哥昏迷评分水平、重症监护病房住院时间、使用血管活性药物治疗、感染性休克和逆转录病毒感染状况与重症监护病房死亡率有统计学显著关联。
本研究显示入住重症监护病房的患者死亡率显著更高。早期识别并将患者收入重症监护病房是降低死亡率的重要因素。患者选择至关重要,因为在资源高度有限的地区,一些死亡可能性高的患者可能无法从入住重症监护病房中获益。