Incidence and Risk Factors of Mortality Among Thoracic Surgical Patients Admitted to Intensive Care Units of Governmental Hospitals in Addis Ababa, Ethiopia: A Multi-Center Retrospective Follow up Study
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Date
2023-06-04
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Addis Ababa University
Abstract
Thoracic surgery is a branch of medicine concerned with the diagnosis and surgical treatment of conditions caused by illness or injury to the thoracic cavity. Intensive care unit gives the intense care and life support for critically ill and injured patients. Patients in a thoracic surgery intensive care unit have severe respiratory and hemodynamic instability. The intensive care unit had a high mortality rate.
Objectives: To assess the incidence and risk factors of mortality among thoracic surgical patients admitted to the intensive care units of Governmental Hospitals in Addis Ababa from December 2020 to December 2022 G.C.
Methods: Multi-center Retrospective follow up study was employed. Two years of patients chart were reviewed from December 2020 to December 2022 in Addis Ababa Hospitals in Tikur Anbessa, Menelik II, and Saint Peter Hospital. All thoracic surgical patients admitted to the intensive care units in the study period were included. 230 patients in the intensive care unit were included. Purposive sampling and simple random sampling technique was used to select the three hospitals and collect the data respectively. The data was collected by using the mobile phone kobo tool box version 2022.3.6. Data were cleaned, checked, and exported into SPSS version 26 for analysis. Bivariate and multivariate logistic regression analysis was done. Finally, a p-value of less than 0.05 in the multivariate logistic regression model was identified.
Result: 230 patients' charts were reviewed in the study with giving a response rate of 100%. The mortality rate was 12.61% with a 95% confidence interval of (0.08, 0.17). Duration of ICU stay >7 days (AOR:4.921,95% CI:1.513,16.002), patients who were not managed by thoracic epidural analgesia (AOR:4.338,95% CI:1.439,13.072), low ICU platelet count (AOR:21.289,95% CI:1.347,336.549) and increased blood transfusion requirements (AOR:3.124,95% CI:1.025,9.519) were identified as a risk factor for ICU mortality.
Conclusion: The study confirmed that the mortality rates were high. Duration of ICU stay greater than 7 days, patients who were not managed by thoracic epidural analgesia, low ICU platelet count, and increased blood transfusion requirements were risk factors for intensive care unit mortality. Therefore health professionals should be cautious for patients who had prolonged stays in the ICU, apply and trend thoracic epidural analgesia for pain management during thoracic surgery, treat the underlying cause of low platelet count, and apply blood conservation strategies and quantify the amount of blood loss perioperatively.
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Incidence, Risk factors, Thoracic surgery, Mortality, Intensive care unit