INCIDENCE AND PREDICTORS OF MORTALITY AMONG ADULT TRAUMA PATIENTS ADMITTED IN THE INTENSIVE CARE UNITS IN COMPREHENSIVE SPECIALIZED HOSPITALS IN NORTHWEST AMHARA, NORTHWEST ETHIOPIA, 2022

Abstract

ABSTRACT Introduction: Trauma is the leading cause of morbidity and mortality among the younger population in the world. Despite many improvements in technology and care, mortality among trauma patients in the intensive care unit is still high. Investigating the incidence and predictors of mortality among trauma patients could have a positive impact on patient outcome. However, as to our search of literatures, there is limited evidence in African countries including Ethiopia. Objective: To assess incidence and predictors of mortality among adult trauma patients admitted to Intensive Care Units of comprehensive specialized hospitals in Northwest Amhara, 2022. Methods: Institutional-based retrospective follow-up study was conducted on trauma patients admitted in the intensive care units from January 9, 2019 to January 8, 2022. Simple random sampling method was used to select 421 patients’ charts. Smart phone and tablet based data collection was done with Kobo toolbox software. Data was exported into STATA version 14.1 for data analysis. Results were explored using descriptive statistics and Kaplan–Meier failure curve together with the log-rank test was fitted to explore the survival difference among groups. The Cox regression model was fitted and variables with p-value <0.2 in the bivariable Cox regression were candidate for the multivariable analysis. In the multivariable Cox proportional hazard regression, an Adjusted Hazard Ratio with 95 % Confidence Intervals were reported to declare the strength of association between mortality and predictors when a P value is <0.05. Result: A total of 392 trauma patients were included in this study with the response rate of 93.1%. The overall incidence of mortality was 5.47 per 100 person-day observation with the median survival time of 14 days and the proportion of death during the study period was 42.1%. In the multivariable cox proportional hazard regression analysis, didn’t get pre-hospital care (AHR= 2.00, 95%CI: 1.13-3.53), Glasgow Coma Scale (GCS) score <9 (AHR= 3.89, 95%CI: 1.67-9.06), presence of complication (AHR= 3.71, 95%CI: 1.29-10.64), hypothermia at admission (AHR= 2.11, 95%CI: 1.13-3.93) and hypotension at admission (AHR= 1.93, 95%CI: 1.01-3.66) were found significant predictors mortality among trauma patients admitted in the ICU. Conclusion and recommendation: The incidence of mortality among trauma patients in the ICU was high. Independent predictors of mortality were didn’t get pre-hospital care, GCS <9, presence of complications, hypothermia and hypotension. Therefore, it would be better if special attention is given for trauma patients who had hypotension, hypothermia and have lower GSC score