Department of Nursing, Injibara Hospital, Injibara, Ethiopia.
Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Biomed Res Int. 2024 Oct 28;2024:4378635. doi: 10.1155/2024/4378635. eCollection 2024.
Although intensive care units (ICUs) are where severe and complicated cases are managed, there is limited evidence on treatment outcomes in Ethiopia. Therefore, this study is aimed at assessing the magnitude and associated factors of mortality among patients with sepsis admitted to ICUs at southern Amhara public hospitals, Ethiopia. A total of 547 medical records of patients with sepsis admitted to the ICUs at Injibara, Debre Markos, and Debre Tabor hospitals in the past 3 years were retrieved from August 10-31, 2022. Multivariable logistic regression analyses were conducted and adjusted odds ratios (AOR) with a 95% confidence interval (CI) were reported, and a value < 0.05 was set to declare the significance of the association. In this study, 46.2% (95% CI: 41.7%-50.3%) of patients with sepsis died during their ICU stay. Respiratory, gastrointestinal, and urinary tract infections contributed to 32.3%, 25.8%, and 9.6% of mortality, respectively. Individuals aged 60 and above (AOR: 4.07; 95% CI: 2.23-7.44), those with a Glasgow Coma Scale ≤ 10 at admission (AOR: 11.27; 95% CI: 4.64-27.37), respiratory site of infection (AOR: 5.38; 95% CI: 2.94-9.86), creatinine level > 1.1 mg/dL (AOR: 4.20; 95% CI: 2.33-7.60), vasopressor use (AOR: 3.13; 95% CI:1.66-5.95), initiation of antibiotics 1-3 h after admission (AOR: 2.80; 95% CI: 1.64-4.76), and a hospital stay of more than 20 days (AOR: 3.44; 95% CI: 1.40-8.46) were significantly associated with mortality. Overall, the mortality rate among patients with sepsis admitted to ICUs in southern Amhara public hospitals was high. Mainly, death was attributed to respiratory infections. Elderly patients and those with deteriorated clinical conditions at admission were at higher risk. Therefore, special attention is needed for elderly patients admitted with respiratory infections, antibiotics should be initiated as early as possible, and interventions must be designed to shorten the length of stay in ICUs.
尽管重症监护病房（ICU）是管理严重和复杂病例的地方，但关于埃塞俄比亚 ICU 中脓毒症患者治疗结果的证据有限。因此，本研究旨在评估在过去 3 年中，在埃塞俄比亚南部阿玛拉公立医院的 ICU 中接受治疗的脓毒症患者的死亡率及其相关因素。
2022 年 8 月 10 日至 31 日，从因吉巴拉、德布雷马科斯和德布雷塔博尔医院的 ICU 中检索了 547 份过去 3 年内接受治疗的脓毒症患者的病历。进行了多变量逻辑回归分析，并报告了调整后的优势比（AOR）和 95%置信区间（CI），并设定 值<0.05 表示关联的显著性。
在这项研究中，46.2%（95%CI：41.7%-50.3%）的脓毒症患者在 ICU 期间死亡。呼吸、胃肠道和尿路感染分别导致 32.3%、25.8%和 9.6%的死亡率。60 岁及以上的个体（AOR：4.07；95%CI：2.23-7.44）、入院时格拉斯哥昏迷量表评分≤10 分的个体（AOR：11.27；95%CI：4.64-27.37）、呼吸部位感染的个体（AOR：5.38；95%CI：2.94-9.86）、肌酐水平>1.1mg/dL 的个体（AOR：4.20；95%CI：2.33-7.60）、使用血管加压药的个体（AOR：3.13；95%CI：1.66-5.95）、入院后 1-3 小时内开始使用抗生素的个体（AOR：2.80；95%CI：1.64-4.76）和住院时间超过 20 天的个体（AOR：3.44；95%CI：1.40-8.46）与死亡率显著相关。
总体而言，在南部阿玛拉公立医院 ICU 中接受治疗的脓毒症患者的死亡率很高。主要原因是呼吸感染。入院时病情恶化的老年患者风险更高。因此，需要特别关注因呼吸感染而入院的老年患者，应尽早开始使用抗生素，并必须设计干预措施以缩短 ICU 住院时间。
