Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
Department of Cardiac Anaesthesia and Critical Care, Uganda Heart Institute, Kampala, Uganda.
BMC Res Notes. 2024 Aug 1;17(1):215. doi: 10.1186/s13104-024-06874-w.
Post-ICU survivors face higher mortality and often require costly rehabilitation or palliative care, such as occupational therapy, physiotherapy and hospice. However, there is a lack of data quantifying the demand for these services, particularly in developing countries like Uganda. Therefore, this prospective cohort study aimed to investigate the 90-day mortality rate, functional status, and mortality risk factors among 121 ICU patients discharged from three tertiary hospital ICUs in Uganda by tracking their vital and physical functional status for three months with follow-ups on days 30, 60, and 90, and identifying risk factors through Cox regression.
The study revealed that 18 out of 121 ICU patients (14.88%, 95% CI: 9.52-22.51%) died within 90 days post-discharge, while 36.36% achieved normal physical functional status. Factors associated with higher 90-day mortality included raised intracranial pressure (HR 1.92, 95% CI: 1.76-2.79, p = 0.04), acute kidney injury (HR 4.13, 95% CI: 2.16-7.89, p < 0.01), and renal replacement therapy (HR 3.34, 95% CI: 2.21-5.06, p < 0.01). The high mortality rate and the fact that nearly two-thirds of patients did not attain normal functional status 90 days post discharge underscores the need for enhanced post-ICU rehabilitation services.
ICU 幸存者面临更高的死亡率，通常需要昂贵的康复或姑息治疗，如职业治疗、物理治疗和临终关怀。然而，缺乏量化这些服务需求的数据，特别是在乌干达等发展中国家。因此，本前瞻性队列研究旨在通过跟踪 121 名从乌干达三家三级医院 ICU 出院的 ICU 患者的生命和身体功能状态三个月，在第 30、60 和 90 天进行随访，来调查他们的 90 天死亡率、功能状态和死亡风险因素，并通过 Cox 回归识别风险因素。
研究表明，121 名 ICU 患者中有 18 人（14.88%，95%CI：9.52-22.51%）在出院后 90 天内死亡，而 36.36%的患者达到了正常的身体功能状态。与 90 天死亡率较高相关的因素包括颅内压升高（HR 1.92，95%CI：1.76-2.79，p=0.04）、急性肾损伤（HR 4.13，95%CI：2.16-7.89，p<0.01）和肾脏替代治疗（HR 3.34，95%CI：2.21-5.06，p<0.01）。高死亡率和近三分之二的患者在出院后 90 天未达到正常功能状态这一事实，突显了加强 ICU 后康复服务的必要性。
