Assessment of Factors affecting intensive care unit admission of critically ill patients from the adult emergency department in Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia.
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Date
2020-06
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Addis Abeba University
Abstract
Background: Critically ill patients are commonly present to the emergency department (ED) and
need early care to improve outcomes. The transfer time for critically ill patients from the ED to
the Intensive care unit (ICU) must be minimal; however, some factors prolong the transfer time,
which may delay intensive care treatment and adversely affect the patient’s outcome.
Objective: to assess factors affecting intensive care unit admission of critically ill patients from
the adult emergency department in Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
Methodology: A cross sectional study design was conducted from January to June2020at the
emergency department of Tikur Anbesa Specialized Hospital. All critically ill patients who need
intensive care unit admission during the study period were included in the study. The data were
collected by chart review and observation. EpiData manager Version.4.6.0.2 and SPSS
Version.23 for windows was used for data entry and analysis, respectively. Descriptive statistics
and bivariate and multivariate logistic regression were used to analyze the data.
Result: From the total of 102 critically ill patients who need ICU admission 84.3% stayed more
than 6 hours in the ED and majority of critically ill patients 26.5% had acute respiratory failure
that requires ventilator support. The median length of stay was 13.5 hours with an IQR of 7-25.5
hours. Shortage of ICU beds 56 (59.2 %) and delays in radiological examination results 13
(12.7%) were found to be the most important factors that delay ICU admission. On bivariate
logistic regression p<0.05male gender (AOR = 0.175, 95% CI: (0.044, 0.693)) and shortage of
ICU bed (AOR= 0.022, 95% CI: (0.002, 0.201)) were found to have a significant association
with delayed intensive care unit admission.
Conclusion: the study found that there was a delay in ICU admission of critically ill patients
from the ED. Shortage of ICU bed, delay in radiological investigation result and other
organizational factors were among the reasons for the prolonged ED stay.
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Keywords
Emergency department, Critically ill patients, ICU admission