Cross Sectional Study on Mortality and Associated Factors in the Adult ICU of Myungsung Christian Medical Center, a Private Hospital in Addis Ababa Ethiopia
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Date
2020-10
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Addis Abeba University
Abstract
Background: Intensive Care Unit (ICU) is a special department of a tertiary hospital for patients
with the most severe and life-threatening conditions. Critical care is a major challenge in
developing countries where health needs often outstrip available resources. In these countries
most of the critical health care facilities are still in their primordial stages of development. The
mortality rate of patients admitted to the ICU is higher in Ethiopia than developed countries.
There are no published data on mortality in ICU of private hospitals in Ethiopia.
Objectives: The objective of this study was to identify mortality and its associated factors in
Myungsung Christian Medical Center, a private hospital in Addis Ababa Ethiopia.
Methods: A cross sectional study of adult patients admitted to the ICU at MCMC from January
2018 to December 2019 was conducted. There were a total of 743 patients in the study period. 47
patients were excluded due to incomplete outcome data and unavailable charts. 37 (10% of
sample size) patients were used for the pilot study to prepare structured checklist. 366 final
sample size was selected by simple random sampling. Data collectors were trained about the
study. Data entry was done using EpiData software and exported to SPSS for data cleaning and
statistical data analysis. Summary statistics, descriptive and analytic statistical procedures were
performed. Ethical clearance was obtained from the Emergency Medicine and Critical Care
department. A formal permission letter was taken to Myungsung Christian Medical Center and
permission was granted.
Results: Out of 366 patients 220 (60.1%) were males and 144 (39.3%) were between the age of
36 – 60 years with a mean age of 50±19.18 years. Sepsis (24.3%), Stroke (16.1%) and Trauma
(14.5%) were the leading causes of admission. 39% had Cancer, 34% had Hypertension and
21.9% had more than one chronic illness. 46.7% of the patients required mechanical ventilator and 22.1% required vasopressors. From the 366 patients, 231 (63.1%) were transferred to ward,
105(28.6%) died, and 16(4.3%) were referred to another hospital. In bivariate logistic regression
age of the patients (>60 years) (COR: 3.54 95% CI: 1.87, 6.68; P< 0.001), those with medical
illness (COR: 2.21 95% CI: 1.35, 3.63 P=0.002), shock (COR: 4.61 95% CI: 2.63, 8.08;
P<0.001), infection on admission (COR:3.05 95% CI: 1.91, 4.89; P<0.001), infection 48 hours
after admission (COR:2.28 95% CI: 1.24, 4.16; P<0.001), mechanical ventilator (COR: 9.94
95% CI: 5.62, 17.59; P<0.001), use of vasopressor (COR: 10.18 95% CI: 5.82, 17.81; P<0.001),
GCS≤8 (COR: 3.51 95% CI: 2.17, 5.69; P<0.001), surgery history within one month of
admission (COR: 0.29 95% CI: 0.16, 0.51; P< 0.001) were significant at p-value <0.05. In
multivariate logistic regression the age of patients > 60 years (AOR:3.13 95% CI: 1.14, 8.58;
P=0.043), shock (AOR:3.74 95% CI: 1.22, 11.26; P=0.019), mechanical ventilator (AOR:13.28
95% CI: 5.22, 33.75; P<0.001), infection on admission (AOR:2.11 95% CI: 1.01, 4.39;
P=0.046), use of vasopressor (AOR:3.86 95% CI: 1.50, 9.92; P=0.050), and GCS ≤ 8 (AOR:2.25
95% CI: 1.103, 4.591; P=0.026) were significantly associated (P value <0.05) with death at ICU
after controlling for other variables.
Conclusion: According to this study, the mortality of patients in the adult ICU of MCMC, a
private medical center in Addis Ababa is similar to the public hospitals. Age>60 years, presence
of shock, use of mechanical ventilator and vasopressor, presence of infection and GCS ≤ 8 were
significantly associated with mortality.
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Keywords
Ethiopia, Intensive Care Unit, Critical Care, Mortality, Adult