Browsing by Author "Endalamaw Wondimagegn"

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    Predictors of 24hr adult emergency department mortality and its magnitude at a tertiary hospital Addis Ababa Ethiopia: Mixed method study
    (Addis Ababa Universtity, 2025) Endalamaw Wondimagegn; Merahi Kefyalew
    The definition of early emergency department mortality differs for different countries. In Ethiopia, the ministry of health define as death within 24 hours of emergency admission, excluding a dead body on arrival. The 2016 transformation guideline targets to decrease the emergency department mortality < 0.6%(1). Objective: The study aims to assess the magnitude of emergency department mortality and its predictors within 24 hour of admission at the adult Tikur Anbessa Specialised Hospital emergency department. Methodology: the study was mixed method study. Initially cross- sectional study, conducted within the study period of October 1, 2024, to September 30, 2025, at the Tikur Anbessa Specialised Hospital adult Emergency department. After the initial quantitative analysis was conducted, and showed that sepsis (54.1%) was the major contributor to deaths, a focused group discussion was conducted with the emergency and critical care postgraduate students on four open ended questions, and the results triangulated with the initial quantitative analysis to elaborate the main findings and suggest solutions. For the quantitative analysis, mean, median, and frequency were used for descriptive analysis. Multivariable logistic regression was conducted to assess the significance of the association. Results: The magnitudes of adult emergency department mortality at Tikur Anbessa Specialised Hospital within 24 hours of admission were 161 out of the 14,276 emergency admissions making the mortality rate 1.128%. Medical causes were the major contributors of the emergency department mortality, and sepsis covers 54.1% of the deaths within 24 hours of admission. Different factors contributed for the increase in mortality of patients with sepsis. Duration of symptoms before ED arrival, <12 hours, and >24hr- 1 week; main diagnosis at admission with cardiovascular and renal were significantly associated for very early mortality. The protective variables in this study were oxygen saturation >90% and being placed in the red or orange. Conclusion and Recommendation: The magnitude of Tikur Anbessa Specialized Hospital was still high, and medical causes, mainly sepsis is the most common cause of death due to different factors. In conclusion TASH should give training on sepsis management and recognition, involve the infectious disease physicians in the daily round and equip the emergency department with material and human resource.