{"title":"Debre Berhan 综合专科医院重症监护室住院病人死亡率的决定因素:回顾性队列研究","authors":"Ermiyas Endewunet Melaku, Besufekad Mulugeta Urgie, Firmayie Dessie, Ali Seid, Zenebe Abebe, Aklile Semu Tefera","doi":"10.2147/PROM.S450502","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.</p><p><strong>Methods: </strong>A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.</p><p><strong>Results: </strong>The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.</p><p><strong>Conclusion and recommendations: </strong>This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.</p>","PeriodicalId":19747,"journal":{"name":"Patient Related Outcome Measures","volume":"15 ","pages":"61-70"},"PeriodicalIF":1.8000,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895994/pdf/","citationCount":"0","resultStr":"{\"title\":\"Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study.\",\"authors\":\"Ermiyas Endewunet Melaku, Besufekad Mulugeta Urgie, Firmayie Dessie, Ali Seid, Zenebe Abebe, Aklile Semu Tefera\",\"doi\":\"10.2147/PROM.S450502\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.</p><p><strong>Methods: </strong>A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.</p><p><strong>Results: </strong>The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.</p><p><strong>Conclusion and recommendations: </strong>This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.</p>\",\"PeriodicalId\":19747,\"journal\":{\"name\":\"Patient Related Outcome Measures\",\"volume\":\"15 \",\"pages\":\"61-70\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-02-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895994/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Patient Related Outcome Measures\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/PROM.S450502\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Patient Related Outcome Measures","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/PROM.S450502","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景:在全球范围内,重症监护服务正在不断发展。然而,在资源有限的环境中,重症监护室的服务却远远落后,而且由于各种原因,重症监护室的死亡率仍然较高。本研究旨在评估入住重症监护室的内科病人死亡率的决定因素:方法:开展了一项为期五年的基于设施的回顾性队列研究。共纳入 2017 年 3 月至 2022 年 2 月期间入住重症监护室的 546 名内科患者。使用结构化问卷进行文件审查以收集数据。输入 Epi Data 的数据由 STATA 进行分析,并使用频率表和图表进行总结。进行二元和多元逻辑回归分析,以确定死亡率的决定因素:总死亡率为 35.9%。大约一半的死亡原因是脓毒性休克、充血性心力衰竭、严重社区获得性肺炎和中风。最常见的直接死因是心肺骤停。研究发现,入院来源、入院时的 GCS 水平、重症监护室住院时间、肌注治疗、脓毒性休克和逆转录病毒感染状况与重症监护室死亡率有显著的统计学关联:本研究显示,重症监护室住院患者的死亡率明显较高。及早发现患者并将其送入重症监护室是降低死亡率的重要因素。患者的选择至关重要,因为在资源高度紧张的地区,一些死亡率较高的患者可能无法从入住重症监护室中获益。
Determinants of Mortality of Patients Admitted to the Intensive Care Unit at Debre Berhan Comprehensive Specialized Hospital: A Retrospective Cohort Study.
Background: The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.
Methods: A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.
Results: The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.
Conclusion and recommendations: This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.