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Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021
BACKGROUND: Critically ill patients have life-threatening conditions requiring immediate vital organ function intervention. But, critical illness in the emergency department (ED) has not been comprehensively described in resource-limited settings. Understanding the characteristics and dynamics of cr...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408204/ https://www.ncbi.nlm.nih.gov/pubmed/37553630 http://dx.doi.org/10.1186/s12873-023-00858-y |
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author | Mboya, Erick A. Ndumwa, Harrieth P. Amani, Davis E. Nkondora, Paulina N. Mlele, Victoria Biyengo, Happines Mashoka, Ramadhan Haniffa, Rashan Beane, Abi Mfinanga, Juma Sunguya, Bruno F. Sawe, Hendry R. Baker, Tim |
author_facet | Mboya, Erick A. Ndumwa, Harrieth P. Amani, Davis E. Nkondora, Paulina N. Mlele, Victoria Biyengo, Happines Mashoka, Ramadhan Haniffa, Rashan Beane, Abi Mfinanga, Juma Sunguya, Bruno F. Sawe, Hendry R. Baker, Tim |
author_sort | Mboya, Erick A. |
collection | PubMed |
description | BACKGROUND: Critically ill patients have life-threatening conditions requiring immediate vital organ function intervention. But, critical illness in the emergency department (ED) has not been comprehensively described in resource-limited settings. Understanding the characteristics and dynamics of critical illness can help hospitals prepare for and ensure the continuum of care for critically ill patients. This study aimed to describe the pattern and outcomes of critically ill patients at the ED of the National Hospital in Tanzania from 2019 to 2021. METHODOLOGY: This hospital-records-based retrospective cohort study analyzed records of all patients who attended the ED of Muhimbili National Hospital between January 2019 and December 2021. Data extracted from the ED electronic database included clinical and demographic information, diagnoses, and outcome status at the ED. Critical illness in this study was defined as either a severe derangement of one or more vital signs measured at triage or the provision of critical care intervention. Data were analyzed using Stata 17 to examine critical illnesses’ burden, characteristics, first-listed diagnosis, and outcomes at the ED. RESULTS: Among the 158,445 patients who visited the ED in the study period, 16,893 (10.7%) were critically ill. The burden of critical illness was 6,346 (10.3%) in 2019, 5,148 (10.9%) in 2020, and 5,400 (11.0%) in 2021. Respiratory (18.8%), cardiovascular (12.6%), infectious diseases (10.2%), and trauma (10.2%) were the leading causes of critical illness. Most (81.6%) of the critically ill patients presenting at the ED were admitted or transferred, of which 11% were admitted to the ICUs and 89% to general wards. Of the critically ill, 4.8% died at the ED. CONCLUSION: More than one in ten patients attending the Tanzanian National Hospital emergency department was critically ill. The number of critically ill patients did not increase during the pandemic. The majority were admitted to general hospital wards, and about one in twenty died at the ED. This study highlights the burden of critical illness faced by hospitals and the need to ensure the availability and quality of emergency and critical care throughout hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-023-00858-y. |
format | Online Article Text |
id | pubmed-10408204 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104082042023-08-09 Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 Mboya, Erick A. Ndumwa, Harrieth P. Amani, Davis E. Nkondora, Paulina N. Mlele, Victoria Biyengo, Happines Mashoka, Ramadhan Haniffa, Rashan Beane, Abi Mfinanga, Juma Sunguya, Bruno F. Sawe, Hendry R. Baker, Tim BMC Emerg Med Research BACKGROUND: Critically ill patients have life-threatening conditions requiring immediate vital organ function intervention. But, critical illness in the emergency department (ED) has not been comprehensively described in resource-limited settings. Understanding the characteristics and dynamics of critical illness can help hospitals prepare for and ensure the continuum of care for critically ill patients. This study aimed to describe the pattern and outcomes of critically ill patients at the ED of the National Hospital in Tanzania from 2019 to 2021. METHODOLOGY: This hospital-records-based retrospective cohort study analyzed records of all patients who attended the ED of Muhimbili National Hospital between January 2019 and December 2021. Data extracted from the ED electronic database included clinical and demographic information, diagnoses, and outcome status at the ED. Critical illness in this study was defined as either a severe derangement of one or more vital signs measured at triage or the provision of critical care intervention. Data were analyzed using Stata 17 to examine critical illnesses’ burden, characteristics, first-listed diagnosis, and outcomes at the ED. RESULTS: Among the 158,445 patients who visited the ED in the study period, 16,893 (10.7%) were critically ill. The burden of critical illness was 6,346 (10.3%) in 2019, 5,148 (10.9%) in 2020, and 5,400 (11.0%) in 2021. Respiratory (18.8%), cardiovascular (12.6%), infectious diseases (10.2%), and trauma (10.2%) were the leading causes of critical illness. Most (81.6%) of the critically ill patients presenting at the ED were admitted or transferred, of which 11% were admitted to the ICUs and 89% to general wards. Of the critically ill, 4.8% died at the ED. CONCLUSION: More than one in ten patients attending the Tanzanian National Hospital emergency department was critically ill. The number of critically ill patients did not increase during the pandemic. The majority were admitted to general hospital wards, and about one in twenty died at the ED. This study highlights the burden of critical illness faced by hospitals and the need to ensure the availability and quality of emergency and critical care throughout hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12873-023-00858-y. BioMed Central 2023-08-08 /pmc/articles/PMC10408204/ /pubmed/37553630 http://dx.doi.org/10.1186/s12873-023-00858-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Mboya, Erick A. Ndumwa, Harrieth P. Amani, Davis E. Nkondora, Paulina N. Mlele, Victoria Biyengo, Happines Mashoka, Ramadhan Haniffa, Rashan Beane, Abi Mfinanga, Juma Sunguya, Bruno F. Sawe, Hendry R. Baker, Tim Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title | Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title_full | Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title_fullStr | Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title_full_unstemmed | Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title_short | Critical illness at the emergency department of a Tanzanian national hospital in a three-year period 2019–2021 |
title_sort | critical illness at the emergency department of a tanzanian national hospital in a three-year period 2019–2021 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408204/ https://www.ncbi.nlm.nih.gov/pubmed/37553630 http://dx.doi.org/10.1186/s12873-023-00858-y |
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