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Patterns of admission and outcome of patients admitted to the intensive care unit of Addis Ababa Burn Emergency and Trauma Hospital.

ABSTRACT: Data on patterns of intensive care unit (ICU) admission including age, and severity of illness is essential in developing better strategies for resource allocation to improve outcomes. A 2-year cross-sectional study of 268 patients using a systematic random sampling and structured questionnaire obtained from the database was conducted with the aim of examining patterns of admission among patients admitted to the ICU of Addis Ababa burn emergency and trauma (AaBET) hospital. Data were entered into Epi-Info version 3.5.3 and exported to SPSS version 24 for analysis. Bivariate and multivariate logistic regression were used for association. A P-value of 0.05 at a 95% confidence interval was declared clinically significant. Of the 268 charts reviewed, 193 (73.5%) of them were men with a mean age of 32.6 years. Trauma accounted for 163 (53.4%) of admissions. Burn admission category, Glasgow coma score of 3-8, and not receiving pre-referral treatment were found to be substantially correlated with mortality in both bivariate and multivariate analysis. Trauma constituted a sizeable cause of ICU admission. Road traffic accidents of traumatic brain injuries were the major causes of admission. Developing good pre-referral care equipped with manpower and ambulance services will improve the outcome.

SUBMITTER: Mamo D

PROVIDER: S-EPMC10113727 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Patterns of admission and outcome of patients admitted to the intensive care unit of Addis Ababa Burn Emergency and Trauma Hospital.

Mamo Dirijit D Aklog Etsegenet E Gebremedhin Yemane Y

Scientific reports 20230419 1

Data on patterns of intensive care unit (ICU) admission including age, and severity of illness is essential in developing better strategies for resource allocation to improve outcomes. A 2-year cross-sectional study of 268 patients using a systematic random sampling and structured questionnaire obtained from the database was conducted with the aim of examining patterns of admission among patients admitted to the ICU of Addis Ababa burn emergency and trauma (AaBET) hospital. Data were entered int ...[more]

PMID: 37076540

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Project description:BackgroundNeonatal hypothermia is a worldwide problem and an important contributing factor for Neonatal morbidity and mortality especially in developing countries. High prevalence of hypothermia has been reported from countries with the highest burden of Neonatal mortality. So the aim of this study was to assess the prevalence of Neonatal hypothermia and associated factors among newborn admitted to Neonatal Intensive Care Unit of Public Hospitals in Addis Ababa.MethodsAn institutional based cross-sectional study was conducted from March 30 to April 30, 2016, in Public Hospitals in Addis Ababa and based on admission rate a total of 356 Neonates with their mother paired were enrolled for the study. Axillary temperate of the newborn was measured by a digital thermometer at the point of admission. Multivariate binary logistic regression, with 95% confidence interval and a p-value < 0.05 was used to identify variables which had a significant association.ResultsThe prevalence of Neonatal hypothermia in the study area was 64%. Preterm delivery (AOR = 4.81, 95% CI: 2.67, 8.64), age of Neonate ≤24 h old (AOR = 2.26, 95% CI: 1.27, 4.03), no skin to skin contact with their mother immediately after delivery (AOR = 4.39, 95% CI: 2.38, 8.11), delayed initiation of breastfeeding (AOR = 3.72, 95% CI: 2.07, 6.65) and resuscitation at birth (AOR = 3.65, 95%CI: 1.52, 8.78) were significantly associated with hypothermia.ConclusionsThe prevalence of Neonatal hypothermia in the study area was high. Preterm delivery, age ≤ 24 h old, no skin to skin contact immediately after delivery, delayed initiation of breastfeeding and resuscitation at birth were independent predictors of Neonatal hypothermia. Therefore attention is needed for thermal care of preterm newborn and use of low-cost thermal protection principles of warm chain especially on early initiation of breastfeeding, skin to skin contact immediately after delivery and warm resuscitation.

Project description:BackgroundGlobally, neonatal sepsis is the leading cause of neonatal mortality and morbidity, particularly in developing countries. Despite studies that revealed the prevalence of neonatal sepsis in developing countries, the outcome of the diseases, barriers for poor outcomes were inconclusive. The aim of this study was to assess the treatment outcome of neonatal sepsis and its associated factors among neonates admitted to neonatal intensive care unit in public hospitals, Addis Ababa, Ethiopia, 2021.MethodsA cross-sectional study was carried out from February 15 to May 10, 2021 on 308 neonates admitted to neonatal intensive care units of Addis Ababa city public hospitals. Hospitals and study participants were selected by lottery and systematic random sampling techniques, respectively. Data were collected through face-to-face interviews with a structured, pretested questionnaire and by reviewing both the maternal and newborn profile cards. Epi-data version 4.6 was used to enter the collected data, which was then exported to SPSS version 26 for analysis. The 95% CI odds ratio is used to determine the direction and strength of the association between the dependent and independent variables.ResultsAmong the total study 308 neonates, 75(24.4%) were died. Regarding the poor treatment outcome of neonatal sepsis, neonates whose mothers <37 weeks of gestational age (AOR = 4.87, 95% CI: 1.23-19.22), Grunting (AOR 6.94: 1.48-32.54), Meconium amniotic stained (AOR = 3.03, 95% CI: 1.02-9.01), Duration of rupture of membrane >18hours (AOR = 3.66, 95% CI: (1.20-11.15), Hypertensive PIH/ Eclampsia (AOR = 3.54, 95% CI: 1.24-10.09), Meropenum (AOR = 4.16, 95% CI: 1.22-14.21) and CRP positive result (AOR = 5.87, 95% CI: 1.53-22.56) were significantly associated with poor treatment outcome of neonatal sepsis.Conclusion and recommendationThe treatment outcomes of neonates were 75.6% recovered and 24.4% died. In this setting, empirical treatment was the cornerstone for managing neonatal sepsis. Professionals who are working in labor and delivery ward screened for mothers preeclampsia and duration of rupture of membrane >18hrs /PROM/ treated with antihypertensive drug and antibiotics for the prevention of neonatal sepsis.

Project description:BackgroundEthiopia witnessed an unprecedented decline in under-5 and neonatal mortalities since 2000. But, neonatal mortality still accounts for the largest proportion of under-five child mortality. Quality of service at hospitals may vary and determine the magnitude of neonatal mortality.ObjectiveTo assess the prevalence and associated factors of neonatal mortality among newborns Admitted to the Neonatal intensive care unit of Gandhi Memorial Hospital Addis Ababa, Ethiopia, 2019.MethodsInstitution-based cross-sectional study was conducted from November 1 to December 31, 2019. A sample of one in every 2 admitted patients was included in the study. our exclusion criterion was neonates who had no mothers or guardians and/or neonatal medical records incomplete for status at discharge. We used the Systematic random sampling technique to select the study participants. A pretested structured interviewer-administered questionnaire and a preliminary tested checklist were used to collect primary and secondary data respectively. Descriptive and summary statistics were performed. A binary logistic regression model was fitted and variables that had a P-value of < 0.05 in the multivariable model were considered statistically significant.ResultsA total of 570 neonates who have mothers were involved in the study giving a response rate of 98.8%. The prevalence of neonatal mortality was 7.7% (95% CI: 5.7, 9.8). Mothers' educational status (No education (AOR 3.37, CI 95%, 1.02-11.20), premature rupture of membrane (prolonged PROM) (AOR 5.59, CI 95%, 1.05-29.76), and birth weight less than 2500gm (AOR 3.23, CI 95%, 1.17-8.90) are the significant factors associated with neonatal mortality.ConclusionThe prevalence of neonatal mortality at Gandhi memorial hospital was generally high. As our finding revealed, neonates who are underweight and whose mothers have no formal education as well as have prolonged PROM have higher odds of neonatal mortality. Thus, clinicians, policymakers, and program managers should give special attention to neonates of none educated mothers, mothers with prolonged PROM, and neonates with low birth weight.

Project description:BACKGROUND:Although respiratory distress is one of the major causes of neonatal morbidity and mortality throughout the globe, it is a particularly serious concern for nations like Ethiopia that have significant resource limitations. Additionally, few studies have looked at neonatal respiratory distress and its predictors in developing countries, and thus we sought to investigate this issue in neonates who were admitted to the Neonatal Intensive Care Unit at Black Lion Specialized Hospital, Ethiopia. METHODS:An institution-based retrospective follow-up study was conducted with 571 neonates from January 2013 to March 2018. Data were collected by reviewing patients' charts using a systematic sampling technique with a pretested checklist. The data was then entered using Epi-data 4.2 and analyzed with STATA 14. Median time, Kaplan-Meier survival estimation curves, and log-rank tests were then computed. Bivariable and multivariable Gompertz parametric hazard models were fitted to detect the determinants of respiratory distress. The hazard ratio with a 95% confidence interval was subsequently calculated. Variables with reported p-values < 0.05 were considered statistically significant. RESULTS:The proportion of neonates with respiratory distress among those admitted to the Black Lion Specialized Hospital neonatal intensive care unit was 42.9% (95%CI: 39.3-46.1%) The incidence rate was 8.1/100 (95%CI: 7.3, 8.9). Significant predictors of respiratory distress in neonates included being male [Adjusted hazard ratio (HR): 2.4 (95%CI: 1.1, 3.1)], born via caesarean section [AHR: 1.9 (95%CI: 1.6, 2.3)], home delivery [AHR: 2.9 (95%CI: 1.5, 5,2)], maternal diabetes mellitus (AHR: 2.3 (95%CI: 1.4, 3.6)), preterm birth [AHR: 2.9 (95%CI: 1.6, 5.1)], and having an Apgar score of less than 7 [AHR: 3.1 (95%CI: 1.8, 5.0)]. CONCLUSIONS:In this study, the proportion of respiratory distress (RD) was high. Preterm birth, delivery by caesarean section, Apgar score < 7, sepsis, maternal diabetes mellitus, and home delivery were all significant predictors of this condition. Based on our findings this would likely include encouraging more hospital births, better control of diabetes in pregnancy, improved neonatal resuscitation and addressing ways to decrease the need for frequent caesarean sections.

Project description:BackgroundInjuries are a major cause of health problems in low- and middle-income countries than in high-income nations. This study aimed to describe injuries and identify factors associated with the emergency department (ED) length of stay (LoS).MethodsThis study was conducted at the Addis Ababa Burn, Emergency, and Trauma (AaBET) hospital in Addis Ababa, Ethiopia. All injured patients who visited the ED between April 1, 2021, and March 30, 2022, were included in the study. Data were collected through a retrospective medical record review. Descriptive statistics were used to present the data and a multivariable binary logistic regression model was used to assess factors associated with LoS in the ED.ResultsA total of 6991 (86.8%) injured patients were studied out of 8055 patients who visited the ED. The majority of the patients were male, 5184 (74.2%), and aged between 18-44 years, 4368 (62.4%). The most common mechanism of injury was road traffic accidents, 2693 (38.5%), followed by falls, 1523 (21.8%). The most commonly reported injured body parts were the head (2179, 31.2%). Of the total injured patients, 101 (1.8%) died. The LoS in the ED was greater than 24 hours for 24.4% (95% CI: 23.3-25.5) of the injured patients, with a mean duration of 2.51 (SD = 5.18) days. Factors significantly associated with a prolonged LoS (>24 hours) in the ED included being residing in outside Addis Ababa in Oromia [AOR: 1.61, 95% CI (1.38-1.88)], Amhara [AOR: 1.56, 95% CI (1.14-2.14)] and other [AOR: 3.93, 95% CI (2.73-5.64)], male [AOR: 1.30, 95% CI (1.09-1.54)], aged 60 years or older [AOR: 1.38, 95% CI (1.03-1.85)]; sustaining injuries from road traffic accident [AOR: 2.43, 95% CI (1.19-4.94)], being triaged to orange [AOR: 3.03, 95% CI (2.40-3.83)] and red zones [AOR:3.37, 95% CI (2.65-4.28)]; having fracture injuries [AOR: 1.95, (1.34-2.83)]; and experiencing contusions and crushing injuries [AOR: 2.63 (1.57-4.42)].ConclusionsInjuries are the major share of cases among ED patients at AaBET hospital. Patients were staying in the ED for longer than the recommended 24 hours by the Ethiopian health system. Intervention measures focusing on injury prevention are necessary to reduce the patient burden on the hospital and strengthen the hospital's capacity to reduce prolonged LoS.

Project description:BackgroundPreterm related complications are the single largest direct cause of neonatal deaths throughout the world, responsible for 35% of the world's neonatal death (1.1 million deaths/year). In Ethiopia preterm related complications are still the leading cause of neonatal mortality. Identifying the hazard time to death and predictors of mortality play an important role to decrease preterm mortality. Therefore, this study aimed to determine the survival and predictors of mortality among preterm neonates admitted to neonatal intensive care unit of Addis Ababa public hospitals, Ethiopia, 2021.MethodAn institutional based prospective follow up study was conducted among 358 preterm neonates admitted to selected public hospitals of Addis Ababa, Ethiopia from February 12 to May 12, 2021. Systematic random sampling was used to recruit each sample and data was collected prospectively using structured questioner. Epi-data version 4.6 and STATA version 16 was used to data entry and analysis respectively. Kaplan Meier failure curve, Log rank tests were computed. Schoenfeld residual test was used to check overall model fitness. Cox proportional hazards models were fitted to identify independent predictors of preterm mortality.ResultAt the end of this cohort, 125(34.9%) of the neonates died, with incidence rate of 36.4/1000 (CI: 0.031-0.044) person-day with the median time to death of 6 days. Born from antepartum hemorrhage mother (AHR: 3.1, CI; 1.4-6.6), lack of Kangaroo mother care (AHR: 5.8, CI; 2.37-14.33), unable to start feeding with in 24 h of admission (AHR: 6.4, CI: 3.33-12.28), apnea (AHR: 2.4, CI: 1.3-4.7) and dehydration (AHR: 2.33, CI: 1.3-4.3) were the identified predictors of time to death.Conclusion and recommendationThe first 7 days of admission was the hazard time to death with median time of 6 days. Being born to antepartum hemorrhage mother, lack of Kangaroo mother care, unable to start feeding with 24-h, Apnea and dehydration were the predictors of time to death. Therefore, intervention that focuses on the identified predictors could have a paramount effect to prolong time to death and reduce preterm mortality.

Project description:BackgroundAnxiety is a common phenomenon in some professions including medical emergency settings. Nurses deal with grief and other psychological disturbances when they lost clients due to death at clinical settings. Thus, the level of anxiety among nurses working at emergency and intensive care unit is expected to higher as a result of life threatening cases and frequent loss of clients at emergency settings. However, the burden of anxiety and its associated factors among nurses working in emergency clinical settings are not well addressed in Ethiopia.MethodsAn institutional based cross-sectional study design was conducted among 415 randomly selected nurses working at emergency and Intensive Care Unit at public hospitals in Addis Ababa. Data were collected using interviewer administered questioner. The Hamilton Anxiety Rating Scale was used to measure level of anxiety symptoms. The collected data were entered to a computer using Epi-Data Version 3.1 and exported to SPSS Version 20.0 for analysis. Binary logistic regression was used to identify factors associated with anxiety. Variables with P- Values of < 0.05 were considered as having statistically significant association with higher level of anxiety symptoms with 95 % confidence intervals.ResultsThe result of this study shows that 19.8 % nurses working at emergency and intensive care unit had a higher level of anxiety symptoms [95 % CI (16.1 %- 23.6 %)]. Marital status{0.28:95 %CI(0.16-0.50)}, cigarette smoking{2.48:95 %CI(1.18-5.18)}, work overload {0.35:95 %CI(0.16,0.76)} and night duty shift{0.41:95 %CI(0.19-0.87)} were factors significantly associated with higher level of anxiety symptoms among nurses working at emergency medical settings.ConclusionsNurses working at emergency and intensive care unit showed higher level of anxiety symptoms than the general population and nurses working at other medical settings. Marital status, cigarette smoking, work overload and night duty shift had statistically significant association with higher anxiety symptoms among nurses working at emergency medical settings. This demonstrates a need for the implementation of counseling services regarding effective coping mechanisms and problem-solving strategies for nurses working at emergency medical settings.

Dataset Information

Patterns of admission and outcome of patients admitted to the intensive care unit of Addis Ababa Burn Emergency and Trauma Hospital.

Publications

Patterns of admission and outcome of patients admitted to the intensive care unit of Addis Ababa Burn Emergency and Trauma Hospital.

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