Predictors of 24hr adult emergency department mortality and its magnitude at a tertiary hospital Addis Ababa Ethiopia: Mixed method study
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Date
2025
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Addis Ababa Universtity
Abstract
The definition of early emergency department mortality differs for different countries.
In Ethiopia, the ministry of health define as death within 24 hours of emergency admission, excluding
a dead body on arrival. The 2016 transformation guideline targets to decrease the emergency
department mortality < 0.6%(1).
Objective: The study aims to assess the magnitude of emergency department mortality and its
predictors within 24 hour of admission at the adult Tikur Anbessa Specialised Hospital emergency
department.
Methodology: the study was mixed method study. Initially cross- sectional study, conducted within
the study period of October 1, 2024, to September 30, 2025, at the Tikur Anbessa Specialised
Hospital adult Emergency department. After the initial quantitative analysis was conducted, and
showed that sepsis (54.1%) was the major contributor to deaths, a focused group discussion was
conducted with the emergency and critical care postgraduate students on four open ended questions,
and the results triangulated with the initial quantitative analysis to elaborate the main findings and
suggest solutions. For the quantitative analysis, mean, median, and frequency were used for
descriptive analysis. Multivariable logistic regression was conducted to assess the significance of the
association.
Results: The magnitudes of adult emergency department mortality at Tikur Anbessa Specialised
Hospital within 24 hours of admission were 161 out of the 14,276 emergency admissions making the
mortality rate 1.128%. Medical causes were the major contributors of the emergency department
mortality, and sepsis covers 54.1% of the deaths within 24 hours of admission. Different factors
contributed for the increase in mortality of patients with sepsis. Duration of symptoms before ED
arrival, <12 hours, and >24hr- 1 week; main diagnosis at admission with cardiovascular and renal
were significantly associated for very early mortality. The protective variables in this study were
oxygen saturation >90% and being placed in the red or orange.
Conclusion and Recommendation: The magnitude of Tikur Anbessa Specialized Hospital was still
high, and medical causes, mainly sepsis is the most common cause of death due to different factors. In
conclusion TASH should give training on sepsis management and recognition, involve the infectious
disease physicians in the daily round and equip the emergency department with material and human
resource.
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Keywords
ED mortality, early mortality, Addis Ababa