School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
School of Nursing, Kamuzu University of Health Sciences, Blantyre, Malawi.
Sci Rep. 2024 Aug 16;14(1):19019. doi: 10.1038/s41598-024-66810-7.
In 2016, a new, improved and modern intensive care unit was constructed at Kamuzu Central Hospital in Lilongwe, Malawi. Having been operational for about 4 years, there has not been a systematic audit to gauge its performance. Therefore, this quantitative retrospective cohort study aimed at investigating the performance of the intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi. We analysed the patterns of admission through 250 clinical cases and their respective outcomes spanning from 1st January 2019 to 31st December 2019 using STATA. Descriptive and inferential statistics were computed. We also had a follow-up discussion with the Head of the unit to better understand the unit's functioning. Out of the 250 admissions, we evaluated 249 case files. About 30.8% of all patients were referred from the main operating theatre, and 20.7% from the casualty (emergency medicine). Head injury (26.7%) and peritonitis (15.7%) were the commonest causes of admission. The overall mortality was 52.2% with more females (57.5%) dying than males (47.9%). Head injury and peritonitis had the highest contribution to the mortality accounting for 25.3% and 16.9% of all deaths respectively. In conclusion, despite the new unit registering an improved performance compared to the old unit's 2012 mortality of 60.9%, the current mortality rate of 52.2% generally reflects a suboptimal performance. The intensive care unit is still grappling with a number of challenges that need immediate attention including few working beds, shortage of critical care specialists and nursing staff and lack of standard admission criteria.
2016 年，马拉维利隆圭的卡姆祖中心医院新建了一个经过改进和现代化的重症监护病房。该病房已经运营了大约 4 年，但尚未进行系统的审计来评估其绩效。因此，这项定量回顾性队列研究旨在调查马拉维利隆圭卡姆祖中心医院重症监护病房的表现。我们通过 2019 年 1 月 1 日至 12 月 31 日期间的 250 例临床病例及其各自的结局，使用 STATA 分析了入院模式。计算了描述性和推断性统计数据。我们还与该部门的负责人进行了后续讨论，以更好地了解该部门的运作情况。在 250 例入院中，我们评估了 249 例病例。所有患者中约有 30.8%是从主手术室转来的，20.7%是从急救室（急诊医学）转来的。头部损伤（26.7%）和腹膜炎（15.7%）是最常见的入院原因。总死亡率为 52.2%，女性死亡率（57.5%）高于男性（47.9%）。头部损伤和腹膜炎导致的死亡率最高，分别占所有死亡人数的 25.3%和 16.9%。总之，尽管新病房的表现优于旧病房 2012 年的 60.9%死亡率，但目前 52.2%的死亡率总体上反映了表现不佳。重症监护病房仍面临着许多需要立即关注的挑战，包括工作床位不足、重症监护专家和护理人员短缺以及缺乏标准的入院标准。
