Assessment of the magnitude of mortality from sepsis and septic shock and associated factors among patients admitted to adult Emergency departments
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Date
2025
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Addis Ababa Universtity
Abstract
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.
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Keywords
Sepsis/Septic shock, Early mortality, Emergency department, Addis Ababa, Ethiopia.