THESIS REPORT SUBMITTED TO DEPARTMNET OF ANESTHESIA, COLLEGE OF MEDICINE AND HEALTH SCIENCES, UNIVERSITY OF GONDAR IN PARTIAL FULFLIMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN ADVANCED CLINICAL ANESTHESIA

Abstract

Abstract Background: Intensive care unit (ICU) is a multidisciplinary staffed and specially equipped area of a hospital dedicated to the management of patients with life-threatening illnesses and provision of intensive care services to critically ill patients is a global enterprise. The care is advancing but in resource-limited settings, it is lagging far behind and ICU mortality is still higher due to various reasons. Objective: To determine the admission pattern and clinical outcomes among patients admitted to a medical intensive care unit of University of Gondar Comprehensive Specialized Hospital 2019. Methods: A 5 years retrospective cross-sectional study was done based on a record review of patients chart and ICU registry from March to April 2019. The data was analyzed using SPSS version 20.0. Both bi-variable and multivariable binary logistic regression analyses were used. Variables of P-value less than 0.2 in bivariate analysis were a candidate for multivariable logistic regression. In multivariable analysis, variables P value of < 0.05 was considered as significantly associated at 95% confidence interval. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) to show the strength of association. Results: A total of 504 patients were admitted to MICU September 2015 to April 2019. Out of whom 268 (53.2%) patients were females. cardiovascular disease 182(36.1%), was the commonest categorical admission diagnosis. The overall mortality rate of the MICU was 38.7 %. In the multivariate analysis, mortality was associated with need for mechanical ventilation (AOR=5.87, 95% CI: 3.24-10.65) and abnormal mental status at admission (AOR=2.8.8, CI: 1.83-4.29). patients who stayed less than four days in MICU are 5 times more likely to dies than who stayed four and more days (AOR=5.58, 95% CI: (3.58- 8.69). Conclusions and Recommendations: In this study, overall MICU mortality is increasing. Need for mechanical ventilator, length of ICU stay and mental status at admission were strongly associated with clinical outcome of patients admitted to MICU admission which seeks attention to improvement acute critical care through the expansion of the care, supply emergency equipment’s and medications