Cargando…
Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia
BACKGROUND: Mechanical ventilation is a life-saving intervention for patients with critical illnesses, yet it is associated with higher mortality in resource-constrained settings. This study intended to determine factors associated with the mortality of mechanically ventilated adult intensive care u...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754825/ https://www.ncbi.nlm.nih.gov/pubmed/36533249 http://dx.doi.org/10.1155/2022/7797328 |
_version_ | 1784851286276964352 |
---|---|
author | Debebe, Finot Goffi, Alberto Haile, Tewodros Alferid, Fetiya Estifanos, Haimanot Adhikari, Neill K. J. |
author_facet | Debebe, Finot Goffi, Alberto Haile, Tewodros Alferid, Fetiya Estifanos, Haimanot Adhikari, Neill K. J. |
author_sort | Debebe, Finot |
collection | PubMed |
description | BACKGROUND: Mechanical ventilation is a life-saving intervention for patients with critical illnesses, yet it is associated with higher mortality in resource-constrained settings. This study intended to determine factors associated with the mortality of mechanically ventilated adult intensive care unit (ICU) patients. METHODS: A one-year retrospective inception cohort study was conducted using manual chart review in ICU patients (age >13) admitted to Tikur Anbessa Specialized Hospital (Addis Ababa, Ethiopia) from September 2019 to September 2020; mechanically ventilated patients were followed to hospital discharge. Demographic, clinical, and outcome data were collected; logistic regression was used to determine mortality predictors in the ICU. RESULT: A total of 160 patients were included; 85/160 (53.1%) were females and the mean (SD) age was 38.9 (16.2) years. The commonest indication for ICU admission was a respiratory problem (n = 97/160, 60.7%). ICU and hospital mortality were 60.7% (n = 97/160) and 63.1% (n = 101/160), respectively. Coma (Glasgow Coma Score <8 or 7 with an endotracheal tube (7T)) (adjusted odds ratio [AOR] 6.3, 95% confidence interval 1.19–33.00), cardiovascular diagnosis (AOR 5.05 [1.80–14.15]), and a very low serum albumin level (<2 g/dl) (AOR 4.9 [1.73–13.93]) were independent predictors of mortality (P < 0.05). The most commonly observed complication was ICU acquired infection (n = 48, 30%). CONCLUSIONS: ICU mortality in ventilated patients is high. Coma, a very low serum albumin level (<2 g/dl), and cardiovascular diagnosis were independent predictors of mortality. A multifaceted approach focused on developing and implementing context appropriate guidelines and improving skilled healthcare worker availability may prove effective in reducing mortality. |
format | Online Article Text |
id | pubmed-9754825 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-97548252022-12-16 Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia Debebe, Finot Goffi, Alberto Haile, Tewodros Alferid, Fetiya Estifanos, Haimanot Adhikari, Neill K. J. Crit Care Res Pract Research Article BACKGROUND: Mechanical ventilation is a life-saving intervention for patients with critical illnesses, yet it is associated with higher mortality in resource-constrained settings. This study intended to determine factors associated with the mortality of mechanically ventilated adult intensive care unit (ICU) patients. METHODS: A one-year retrospective inception cohort study was conducted using manual chart review in ICU patients (age >13) admitted to Tikur Anbessa Specialized Hospital (Addis Ababa, Ethiopia) from September 2019 to September 2020; mechanically ventilated patients were followed to hospital discharge. Demographic, clinical, and outcome data were collected; logistic regression was used to determine mortality predictors in the ICU. RESULT: A total of 160 patients were included; 85/160 (53.1%) were females and the mean (SD) age was 38.9 (16.2) years. The commonest indication for ICU admission was a respiratory problem (n = 97/160, 60.7%). ICU and hospital mortality were 60.7% (n = 97/160) and 63.1% (n = 101/160), respectively. Coma (Glasgow Coma Score <8 or 7 with an endotracheal tube (7T)) (adjusted odds ratio [AOR] 6.3, 95% confidence interval 1.19–33.00), cardiovascular diagnosis (AOR 5.05 [1.80–14.15]), and a very low serum albumin level (<2 g/dl) (AOR 4.9 [1.73–13.93]) were independent predictors of mortality (P < 0.05). The most commonly observed complication was ICU acquired infection (n = 48, 30%). CONCLUSIONS: ICU mortality in ventilated patients is high. Coma, a very low serum albumin level (<2 g/dl), and cardiovascular diagnosis were independent predictors of mortality. A multifaceted approach focused on developing and implementing context appropriate guidelines and improving skilled healthcare worker availability may prove effective in reducing mortality. Hindawi 2022-12-08 /pmc/articles/PMC9754825/ /pubmed/36533249 http://dx.doi.org/10.1155/2022/7797328 Text en Copyright © 2022 Finot Debebe et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Debebe, Finot Goffi, Alberto Haile, Tewodros Alferid, Fetiya Estifanos, Haimanot Adhikari, Neill K. J. Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title | Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title_full | Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title_fullStr | Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title_full_unstemmed | Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title_short | Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia |
title_sort | predictors of icu mortality among mechanically ventilated patients: an inception cohort study from a tertiary care center in addis ababa, ethiopia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754825/ https://www.ncbi.nlm.nih.gov/pubmed/36533249 http://dx.doi.org/10.1155/2022/7797328 |
work_keys_str_mv | AT debebefinot predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia AT goffialberto predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia AT hailetewodros predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia AT alferidfetiya predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia AT estifanoshaimanot predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia AT adhikarineillkj predictorsoficumortalityamongmechanicallyventilatedpatientsaninceptioncohortstudyfromatertiarycarecenterinaddisababaethiopia |