Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study

Abstract

Background

The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.

Methods

A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.

Results

The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.

Conclusion and Recommendations

This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.

Keywords:

• intensive care unit
• ICU mortality
• determinants of ICU mortality

Abbreviations

AOR, Adjusted Odds Ratio, ARDS, Acute Respiratory Distress Syndrome; CHF, Congestive Heart Failure; CI, Confidence Interval; DBCSH, Debre Berhan Comprehensive Specialized Hospital; HIV, Human Immunodeficiency Virus; ICU, Intensive Care Unit.

Data Sharing Statement

The data used and/or analysed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

All methods of this research were done in accordance with the Declaration of Helsinki. Ethical clearance and approval to conduct the research was obtained from Debre Berhan University, Asrat Woldeyes Health Science Campus, Institutional Review Board (IRB) office. Official letters were written from the IRB office to the Debre Berhan Comprehensive Specialized Hospital. Formal letter of permission was obtained from Debre Berhan Comprehensive Specialized Hospital administrative body. Informed consent of study participants was exempted (waived) by the IRB office of the university since the study was a retrospective study based on the chart review of patients admitted to ICU and discharged over the past five years. The identity of the patients was coded and unspecified in the research process.

Acknowledgments

The authors greatly appreciate the cooperation and support of all participants and are grateful to data collectors and supervisors.

Author Contributions

All authors made a significant contribution to the work reported, whether that is, in the conception, study design, execution, acquisition of data, analysis, interpretation, drafting, revising, and critically reviewing the article. All authors gave final approval of the version to be published; have agreed to the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. All authors read and approved the final manuscript and approved its submission for publication.

Disclosure

The authors declare that they have no competing interests in this work.