Abstract:
Abstract
Background: Critical illness is a serious global health care burden. Although a high number of
patients are being admitted to intensive care units (ICU), the mortality rate from ICUs remains
high, especially in low and middle-income countries. There is limited information about
mortality and its predictors in the ICU regarding surgical patients. Hence, this study was
designed to investigate the survival status of surgical patients in the ICU and its predictors.
Objective: To assess the admission pattern, incidence, and predictors of mortality among
patients admitted to the surgical intensive care unit at the University of Gondar Comprehensive
and Specialized Hospital, Gondar, Ethiopia, from September 2019 to April 2022.
Methods: An institution-based retrospective follow-up study was conducted among all surgical
patients that were admitted to the ICU from [2019–2022] at UOGCSH, Gondar, Ethiopia. Data
were extracted from patient charts with a pretested data extraction tool, entered into Epi-data
4.6.0, and analyzed with STATA 14. A Kaplan-Meier curve and a long rank test were used to
estimate the failure time and compare failure curves between variables. Bivariate and
multivariate Cox proportional hazards regression models were performed to identify the
independent factors for mortality.
Results: 388 patients’ charts were reviewed with the response rate of 87.98%. A total of 148
(38.1%) surgical patients were died during follow up period with incidence rate of 2.58
(95%CI: 2.20, 3.03) per 1000 person-hours observations with the median survival time of 264
hours. Potassium level< 3.5 (AHR: 3.46, 95% CI (1.83-6.55), potassium level >5.0 (AHR:2.41,
95% CI (1.29-4.51), hypoxia (AHR:1.66, 95% CI (1.10-2.48), GCS score <9 (AHR: 4.06, 95%
CI (1.51-10.89), mechanical ventilator used (AHR:0.12, 95%CI (0.03-0.45), didn’t receive
thromboprophylaxis (AHR:10.8,95% CI (6.04-19.29), didn’t receive enteral feeding
(ARH:3.56, 95% CI (2.20-5.78) were independent predictors of mortality.
Conclusion: This finding showed that the mortality of surgical patients in the ICU was high.
The independent predictors of mortality were hypokalemia, hyperkalemia, GCS <9, mechanical
support, hypoxia, didn’t get thromboprophylaxis and enteral feeding. Patients with those
predictors should be given extra care to reduce their risk of death.
Keywords: incidence; intensive care unit; mortality; predictors; surgical
