Factors associated with mortality in surgical patients admitted to a low-resource mixed intensive care unit: a cross-sectional study.

BACKGROUND

Providing critical care is essential for improving health outcomes, particularly in low-resource settings such as the Democratic Republic of the Congo (DRC). However, there is a significant lack of data regarding the management and outcomes of critically ill surgical patients in this region. This study aimed to investigate the factors associated with mortality among surgical patients admitted to the intensive care unit (ICU) at HEAL Africa Hospital in eastern DRC.

METHODS

This retrospective cross-sectional study analyzed data from surgical patients admitted to the ICU between January 2021 and June 2023. Information was extracted from the ICU registry, including demographics, reasons for admission, management details, length of stay, and mortality rates. Categorical data were presented as frequencies, and logistic regression was used, with a p-value of less than 0.05 considered significant.

RESULTS

Out of 807 patients admitted to the ICU, 368 were surgical patients (43.12%). The cohort had a male predominance (1.6:1) with a median age of 31 years. The primary reason for admission was postoperative monitoring (57.2%). The overall mortality rate was 21.3%. Univariate analysis identified statistically significant risk factors for increased mortality: male sex (p = 0.004), age (p = 0.0409), need for mechanical ventilation (p < 0.0001), involvement in neurosurgery (p = 0.03), and non-operative management (p < 0.0001). Multivariate analysis confirmed that the need for mechanical ventilation (p < 0.0001) and the non-operative management (p < 0.0001) was significantly associated with increased mortality.

CONCLUSION

The burden of surgical critically ill patients in eastern DRC is substantial. Non-operative management and the requirement for mechanical ventilation were identified as factors influencing mortality among these patients. To tackle this pressing issue, it is essential to enhance critical care protocols, invest in the training of healthcare professionals, and allocate resources effectively.

CLINICAL TRIAL NUMBER

Not applicable.