Emergency Medicine

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Assessment of Knowledge, Attitude, Practice and Associaed Factors Regarding Prehospital Care Delivery for Trauma Patients among Health Care Professionals Practicing in Health Centers in Addis Ababa
(Addis Ababa University, 2024-01-23) Seid Hussien; Kalkidan Krbede
Pre-hospital emergency care refers to a medical care provided to patients from the scene to arrival in hospital including turning on an emergency squad of receiving hospital. Poor prior to hospital arrival emergency trauma care practices, attitudes, or understanding can have a negative impact on patients' health outcomes.
Assessment of the magnitude of mortality from sepsis and septic shock and associated factors among patients admitted to adult Emergency departments
(Addis Ababa Universtity, 2025) Assefa Petros; Temesgen Beyene; Tigist Zewdu
Sepsis and septic shock remain major causes of morbidity and mortality worldwide, with disproportionately high burden in low and middle-income countries. Evidence on early mortality and its determinants in Ethiopian Emergency departments is limited. This study aimed to determine the magnitude of mortality from sepsis and septic shock and associated factors among adult patients admitted to the emergency departments of Addis Ababa teaching tertiary hospitals. Methods: An institutional based retrospective chart review was conducted between October 2023 to October 2025 among the total of 141 eligible medical records of patients with sepsis or septic shock that admitted to the EDs at Tikur Anbessa Specialized Hospital and St. Paul Hospital Millenium Medical College. Multivariable logistic regression was conducted and adjusted odds ratios (AOR) with a 95% confidence interval (CI) were reported, and statistical significance was set at a p value of less than 0.05. Results: Among 141 patients, majority 57% were females and 42.6% were males, with median age range was 40-59years and about half, 47.5% of the had qSOFA score ≥ 2. The 24-hour emergency departments’ mortality among patients with sepsis and septic shock was 31.9% (95% CI: 24.2%–40.3%). Respiratory infections accounted for 49.6% of admissions, followed by gastrointestinal (38.3%) and central nervous system infection (4.3%). Mortality was significantly associated with multiorgan failure 2.9(1.1_7.4), length of EDs stay 12 hours 4.99(2.046_12.21), malignancy 2.6(1.1_6.2), qSOFA score ≥2 3.49(1.5_7.8) and comorbidities 3.3(1.125_ 9.84). Conclusion: Overall, the magnitude of ED mortality rate among patients with sepsis or septic shock admitted to EDs of Addis Ababa teaching hospitals was high. Respiratory and gastrointestinal infections were leading causes of death, emphasizing the need for targeted interventions. Clinical indicators such as altered mentation, hypotension, multiorgan failure, comorbidity, and prolonged ED significantly increased the risk of mortality. Enhancing early identification, optimizing resuscitation within the golden hours, and improving timely interventions are critical to reducing sepsis related mortality.
Clinical Profile & Mortality of Louse-Borne Relapsing Fever Among Patients Seen at Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital from July 2022 To July 2023 -Addis Ababa, Ethiopia Retrospective Chart Review
(Addis Ababa University, 2024-01-04) Kalkidan Zenebe; Aklilu Azazh
Relapsing fever is a vector-born acute recurrent febrile illness caused by Borrelia recurrentis. LBRF is an important re-emerging disease that remains a significant public health concern globally but is currently prevalent in developing countries like the highlands of Ethiopia, Kenya, and Sudan, however, there is limited research on relapsing fever, therefore, it is to assess the clinical profile, and mortality rate in patients with relapsing fever in Addis Ababa
Clinical Profile & Mortality of Louse-Borne Relapsing Fever Among Patients Seen at Zewditu Memorial Hospital and Tikur Anbessa Specialized Hospital from July 2022 To July 2023 -Addis Ababa, Ethiopia Retrospective Chart Review
(Addis Ababa University, 2024-01-13) Zenebe Kalkidan
Relapsing fever is a vector-born acute recurrent febrile illness caused by Borrelia recurrentis. LBRF is an important re-emerging disease that remains a significant public health concern globally but is currently prevalent in developing countries like the highlands of Ethiopia, Kenya, and Sudan, however, there is limited research on relapsing fever, therefore, it is to assess the clinical profile, and mortality rate in patients with relapsing fever in Addis Ababa.
Clinical Profile and Outcome of Adult Hiv-Positve Patients Presenting to the Emergency
(Addis Ababa Uinverstiy, 2025) Ayenew Genet; Bitania Debalkew; Aklilu Azazh
HIV has been a global health problem since its identification. Despite a decline in new infections, many patients still present to emergency departments with advanced disease and critical systemic infections in Ethiopia. Objective: The main aim of this study was to assess the clinical profile and outcomes of adult HIV-positive patients presenting to the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: This study involved a retrospective cross-sectional electronic medical records review from January 1 to June 30, 2025, taking place in Tikur Anbessa Specialized Hospital adult emergency department. Data was extracted using a structured Kobo tool and then analyzed with SPSS v27. Multivariable logistic regression was applied to identify the factors associated with mortality, with a p-value of <0.05 regarded as statistically significant. Results: Out of a total of 104 HIV-positive patients included, the mean age was 45.78 ±14.25 years, and 64(61.5%) were females. The leading clinical presentations were vomiting (14.1%), diarrhea (10.5%), and fatigue (10.1%). Outcomes included ICU admission at 3.8%, and emergency department mortality at 14.2%. Advanced WHO clinical stage (AOR=6.068, 95%CI:1.273-28.880, P=0.024), high white blood cell count(AOR=1.205, 95%CI:1.015- 1.429,P=0.033), and hemoglobin (AOR=0.704, 95% CI: 0.540-0.918,P=0.009) were significant independent predictors of mortality. The majority (76.4%) stayed in the ED for ≥24 hours, with a median stay of 2 days (IQR: 1–3). Conclusion: Most HIV-positive adults presenting Tikur Anbessa Specialized Hospital emergency department had advanced diseases, high mortality, and prolonged ED stays. Advanced WHO clinical stage, high WBC, and low hemoglobin are independently associated with increased mortality. Findings underscore the need for early HIV diagnosis, proper monitoring, and optimized care.
Clinical Profile and Outcome of Adult Hiv-Positve Patients Presenting to the Emergency
(Addis Ababa Uinverstiy, 2025) Ayenew Genet; Bitania Debalkew; Aklilu Azazh
: HIV has been a global health problem since its identification. Despite a decline in new infections, many patients still present to emergency departments with advanced disease and critical systemic infections in Ethiopia. Objective: The main aim of this study was to assess the clinical profile and outcomes of adult HIV-positive patients presenting to the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: This study involved a retrospective cross-sectional electronic medical records review from January 1 to June 30, 2025, taking place in Tikur Anbessa Specialized Hospital adult emergency department. Data was extracted using a structured Kobo tool and then analyzed with SPSS v27. Multivariable logistic regression was applied to identify the factors associated with mortality, with a p-value of <0.05 regarded as statistically significant. Results: Out of a total of 104 HIV-positive patients included, the mean age was 45.78 ±14.25 years, and 64(61.5%) were females. The leading clinical presentations were vomiting (14.1%), diarrhea (10.5%), and fatigue (10.1%). Outcomes included ICU admission at 3.8%, and emergency department mortality at 14.2%. Advanced WHO clinical stage (AOR=6.068, 95%CI:1.273-28.880, P=0.024), high white blood cell count(AOR=1.205, 95%CI:1.015- 1.429,P=0.033), and hemoglobin (AOR=0.704, 95% CI: 0.540-0.918,P=0.009) were significant independent predictors of mortality. The majority (76.4%) stayed in the ED for ≥24 hours, with a median stay of 2 days (IQR: 1–3). Conclusion: Most HIV-positive adults presenting Tikur Anbessa Specialized Hospital emergency department had advanced diseases, high mortality, and prolonged ED stays. Advanced WHO clinical stage, high WBC, and low hemoglobin are independently associated with increased mortality. Findings underscore the need for early HIV diagnosis, proper monitoring, and optimized care.
Clinical profile and outcome of patients without attendants admitted at the Emergency Department
(Addis Ababa Universtity, 2025) Solomon Tegen; Merahi Kefyalew; Finot Debebe
Emergency Department provides timely intervention for patients with life threatening emergency medical and surgical conditions. This is possible through the support and involvement of families or caregivers during clinical evaluation and management. However, there are scenarios where patients present to emergency department might be attended to solely by the patient or by other agents, such as police or passersby, where their presence during the patient’s emergency stay is impractical. Understanding the clinical characteristics and outcomes of patients managed without attendants is important for optimizing emergency care delivery and informing health care planning. Objective: This study determines the prevalence, clinical profile, and outcome of patients without attendants in selected governmental hospitals of Addis Ababa. Methods: A prospective cross-sectional study was conducted from August 1/2025, to November 1/2025, in a selected governmental hospital of Addis Ababa. After obtaining ethical clearance, data were collected by trained personnel from patients, using a data extraction tool and a questionnaire from patient documents/EMR. Data was cleaned and then exported using SPSS version 26. Descriptive statistics, including frequency and percentage, were generated for the prevalence, some clinical profiles, and outcomes of patients without attendant emergency department admissions. Considering p-value <0.05 with 95% confidence interval, a logistic regression model was conducted to see the strength of association between major outcomes and clinical profile of patients without attendants. Result: One hundred thirty-three (79.2%) participants were male. The median age was 35 years (IQR:25-46). The prevalence of patients without attendants was 2.57%. The median length of stay is 11.2days (IQR:5.6-19.7), which looks quite exaggerated. 34(19.6%) of patients died. Male sex and high acuity patients (triaged as red and orange) were found to be significantly associated with patient mortality. Conclusion: The length of stay and mortality rates in patients without attendants are higher than ED standards. Mortality is significantly associated with male sex and high acuity triage category
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.
Triage Knowledge and Perceived Skills Among Nurses Working in Adult Emergency Departments of Selected Public Hospitals in Addis Ababa, Ethiopia, 2023.
(Addis Ababa University, 2023-06) Mengist Bete; W Andualem; K Sofia
Background: Triage is an essential function in emergency department. Knowledge of nurses working at triage has been cited as an influential factor in triage decision-making. As there are increased numbers of clients with life threatening traumatic injuries and medical patients in the emergency department in Ethiopia, triage knowledge and skill are an essential competency required for the nurses working in emergency department. Since there is limited study with in Addis Ababa hospitals regarding the knowledge and skills of triage among nurses working in the emergency departments, it is necessary to assess emergency nurses’ triage knowledge and skills including its related factors. Objective: To assess knowledge and perceived skills of nurses towards triage and associated factors among nurses working in adult emergencydepartment of three selected public hospitals in Addis Ababa, Ethiopia, 2023. Methods: A cross-sectional study design was used. Three hospitals were selected from the total of 13 public hospitals purposely. A census sampling technique was used to obtain a required sample size. A standardized pretested self-administered questionnaire by open data kit (ODK)version 2022.1.2 was used. The questions were coded and the skip logic was properly prepared on the Kobo Toolbox server before data collection. Finally, it was exported to SPSS version 27 for final analysis. Bivariate analysis at a P-value of 0.25 and multivariable analysis at a P-value of 0.05 was applied. Results was presented using tables, figures and texts. Results: A total of 179participants were included in this study. Theproportion of poor triage knowledge and perceived poor triage skill of nurses were 58.1% and 50.3%, respectively.Educational level and triage experience of nurses were significant predictors of triage knowledge,while training experience and availability of triage equipment’s were significant predictors of perceived triage skill. Conclusion and recommendation: The triage knowledge and skill were found to be at low level.As nurse’s knowledge about triage is a key tool in triage decision making, there is the need to improve on nurse’s knowledge level and skills in triaging at the ED.

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