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成人急诊科死亡患者早期死亡率的决定因素。

Determinants of Early Mortality Among Deaths at Adult Emergency Departments in Southern Ethiopia.

机构信息

School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

Adare General Hospital, Hawassa, Ethiopia.

出版信息

J Emerg Med. 2024 Nov;67(5):e464-e474. doi: 10.1016/j.jemermed.2024.07.018. Epub 2024 Aug 14.

Abstract

BACKGROUND

In Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia.

OBJECTIVE

The main objective of this study is to assess the prevalence and associated factors of early mortality among deaths in adult EDs at selected public hospitals in Hawassa, southern Ethiopia.

METHODS

An institutional-based retrospective cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in the adult EDs of selected public hospitals in the past 2 years. The data were collected using a standardized and pretested data abstraction tool using the Kobo Toolbox data collection tool. Logistic regression analyses were carried out to assess the strength of the association. Statistical significance was declared at p-value < 0.05, and an adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association.

RESULT

According to the results of the current study, 288 patients, or 78% of the total, passed away within 72 h of admission to the ED. The following variables were significantly associated with early mortality: delayed initial intervention (AOR 2.338), red triage categories (AOR 3.9), lack of investigation (AOR 3.4), comorbid illness (AOR 3.2), absence of prehospital treatment (AOR 4.2), and road traffic accidents (AOR 4.1).

CONCLUSION

There was an increased early mortality rate seen in this investigation. The following factors were significantly associated with an early death in the ED: comorbidity, delayed intervention, red warning score, road traffic accidents, absence of prehospital treatment, and lack of diagnostic testing. By addressing the variables that are strongly linked to an early mortality, every intervention should be undertaken to reduce the risk of an early death.

摘要

背景

在埃塞俄比亚,急诊科(ED)入院后的前 3 天(72 小时)占所有死亡人数的一半以上(59.8%)。然而,人们对南部埃塞俄比亚早期死亡率及其相关因素知之甚少。

目的

本研究的主要目的是评估在选定的哈瓦萨公立医院成人急诊科死亡的患者中早期死亡率的流行率及其相关因素。

方法

采用基于机构的回顾性横断面研究设计。采用系统随机抽样技术,选择过去 2 年在选定的公立医院成人急诊科死亡的 369 份病历。使用 Kobo 工具箱数据收集工具,使用标准化和预测试的数据提取工具收集数据。采用逻辑回归分析评估关联强度。统计显著性定义为 p 值 < 0.05,使用调整后的优势比(AOR)和 95%置信区间报告关联强度。

结果

根据本研究的结果,288 名患者,即总数的 78%,在急诊科入院后 72 小时内死亡。以下变量与早期死亡显著相关:初始干预延迟(AOR 2.338)、红色分类类别(AOR 3.9)、缺乏检查(AOR 3.4)、合并症(AOR 3.2)、院前治疗缺失(AOR 4.2)和道路交通伤害(AOR 4.1)。

结论

本研究中观察到早期死亡率增加。以下因素与急诊科早期死亡显著相关:合并症、干预延迟、红色预警评分、道路交通伤害、院前治疗缺失和缺乏诊断性检查。通过处理与早期死亡密切相关的变量,应采取每一项干预措施来降低早期死亡的风险。

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