Clinical outcomes and factors associated with mortality among adults admitted to the intensive care unit at Hawassa University Comprehensive Specialized Hospital, Ethiopia: retrospective chart review

TL;DR

This study examines ICU mortality in Ethiopia, finding that factors like mechanical ventilation and unconscious admission status are linked to higher death rates.

Contribution

The study provides new insights into ICU mortality factors in a low-resource Ethiopian setting.

Findings

Overall ICU mortality was 28%.

Mechanical ventilation and unconscious mental status at admission were strongly associated with mortality.

Shorter ICU stays increased mortality risk.

Abstract

Intensive Care Units manage patients with life-threatening conditions. Despite all efforts, mortality in these units remains high in many low-resource settings. There is limited evidence on the outcomes and Factors Associated with mortality among adult patients admitted to intensive care in the Sidama region of Ethiopia.

To assess clinical outcomes and Factors Associated with Mortality among Adults Admitted to the Intensive Care Unit at Hawassa University Comprehensive Specialized Hospital, Ethiopia.

A facility-based retrospective chart review was conducted among adult patients admitted to the ICU of Hawassa University Comprehensive Specialized Hospital between 1 January 2022 and 10 April 2024. Data were extracted from 401 patient charts using a structured checklist. The study participants’ cards were selected consecutively using a list of their medical record numbers. The collected data were checked for completeness and consistency. The coded data were checked and entered into the EPI data version 4.6. The data were then exported into SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with ICU mortality. Variables with a p-value < 0.05 were considered significant.

The overall intensive care unit mortality was 28% (95% CI: 23.5–32.5). In the multivariate analysis, mortality was associated with mechanical ventilation requirements in patients (AOR = 5.71, 95% CI: 1.49–21.8) and unconscious mental status at admission (AOR = 4.76, 95% CI: 1.38–16.44). Patients who stayed less than four days in ICU are two times more likely to die than those who survived (AOR = 2.10, 95% CI: 1.25–3.53).

In this study, Mortality among adult patients admitted to the ICU was high. Mechanical ventilation, impaired level of consciousness at admission, and shorter ICU length of stay were factors associated with increased mortality. These findings highlight the need for improved early identification, stabilization, and management of critically ill patients in resource-limited settings.

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