Causes of admissions and in-hospital mortality among patients admitted to critical care units in primary and secondary hospitals in Vietnam in 2018: a multicentre retrospective study

OBJECTIVE: The goal of this study was to describe the burden of disease and in-hospital mortality among patients admitted to the critical care units (CCUs) in Vietnam. DESIGN: Retrospective study. SETTING: The whole 1-year data of admissions to CCUs were collected from 34 hospitals from January to December 2018. PARTICIPANTS: A total of 44 013 episodes of admission to CCUs were analysed. PRIMARY OUTCOME: We used International Classification of Diseases-11 codes to assess the primary diagnosis associated with admissions and in-hospitals mortality. Years of life lost (YLL) measure was further used to estimate the burden of disease. RESULTS: The 0–5 years and ≥70 years age groups accounted for 14.8% (6508/44 013) and 26.1% (11 480/44 013) of all admissions, respectively. The most common diagnoses were diseases of the respiratory system (27.8% or 12 255/44 013), followed by unclassified symptoms, signs or clinical findings (13% or 5712/44 013), and diseases of the circulatory system (12.2% or 5380/44 013). Among 28 311 patients with available outcome data, 1681 individuals (5.9%) died during the hospitalisation. The in-hospital mortality rate increased with age, from 2.8% (86/3105) in under 5 years old age group to 23.1% (297/1288) in over 90-year age group. Diseases of the respiratory system was the leading causes of death in term of number of deaths (21.8% or 367/1681 of all deaths). Diagnosis of sepsis was associated with the highest in-hospital mortality (36.8%). The overall YLL under the age of 75 were 1287 per 1000 patients. CONCLUSIONS: CCUs in Vietnam faced wide differences in the burden of diseases. Sufficient infrastructure and adequate multidisciplinary training are essential to ensure the appropriate response to the current needs of population.