ADMISSION PATTERN, INCIDENCE, AND PREDICTORS OF MORTALITY AMONG PATIENTS ADIMITTED TO SURGICAL INTENSIVE CARE UNIT AT UNIVERSITY OF GONDAR COMPRHENSIVE SPECIALIZED HOSPITAL IN GONDAR, ETHIOPIA: 2022 G.C.RETEROSPECTIVE FOLLOW UP STUDY

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