Assessment of clinical profile and magnitude of early mortality in the adult emergency department of TASH, Addis Ababa city, Ethiopia.
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Date
2020-06
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Addis Abeba University
Abstract
Background: The classification of ED mortality is important because it identifies a group of
patients who can benefit from the treatment that are provided at the department. Early mortality
is defined as death within 72 hrs.‟ of ED presentation (7) and 'very early' ED mortality is
defined as death within 24 hours (8). This 'very early' mortality group represents the most
urgently ill patients likely to benefit from ED care interventions to prevent mortality.
Objective: The purpose of this is study to assess clinical profile and magnitude of early
emergency department mortality among patients presented to the adult emergency department
of Tikur Anbesa Specialized Hospital from March 1,2018-March 1, 2020, Addis Ababa,
Ethiopia.
Methodology: A cross-sectional study design was used to assess clinical profile and Magnitude
of early mortality in the adult emergency department, Tikur Anbesa Specialized Hospital;
Addis Ababa, Ethiopia, From March 1, 2018 to March 1, 2020. The data were collected by
review of patients‟ medical record cards. Data was entered by Epi data 4.2.1 and analyzed by
SPSS Version 23. Binary and multiple logistic regression analysis were used for the
association. Statically significance was P-value<0.05 at CI 95%.
Result: Of analyzed 506 charts, overall early ED mortality rate was 1.68 %, with male to
female ratio 1.1:1. From multiple logistic regression results, it was found that, patients who
were triaged as Green were 4.2 times more likely to die after 24 hrs of admission.‟ than patients
who triaged as red. (AOR= .235 95% CI .101, .546). Patients who presented with chief
compliant of >1 week duration were 2.1 times more likely to die after 24 hrs of admission.‟
than who came with chief complaints of 4-24 hrs.‟ duration (AOR = .471, 95% CI: (.256,
.866.). From co morbid diseases HIV patients were 2.7 times more likely to die after 24 hrs.‟
than Asthmatic patients.‟ (AOR = 2.720, 95% CI: (1.013, 7.300).
Conclusion and recommendations: even though important steps were done to boost the
emergency care there are still gaps. It has been found triage acuity; comorbid disease and
duration of symptoms of patients were associated with Early ED mortality. Therefore it is
essential to improve the quality of care of ED, to reduce the magnitude of preventable ED
mortalities.
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Keywords
Early Mortality, Death, Emergency-Department