Magnitude of in hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022

Abstract

Introduction: Laparotomy is an incision into the abdominal cavity to treat severe abdominal pathology and save life. It is done both in elective and emergency conditions and carries significant deaths in both developed and developing countries, including Ethiopia. Studies regarding the magnitude of in hospital mortality among patient undergone laparotomy and associated factors are limited. Objective: To assess the magnitude of in hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022. Method: An institutional based retrospective cross-sectional study was conducted from January 1 , 2017- December 31, 2021. Data were collected by systematic random sampling method and extracted based on a structured pretested data abstraction sheet from 548 patients’ medical records and registers. Data were checked for completeness, consistency, coded, entered using EPI data version 4.6, cleaned and analysed using SPSS version 25. Variables with a p value < 0.2 at bi-variable logistic regression analysis were included in multivariate logistic regression analysis. The model's fitness was verified with the Hosmer-Lemeshow test. Using adjusted odds ratio (AOR) at 95% CI and p value 0.05, a statistically significant value was declared. Results: A total of 512 patients’ records/ charts were reviewed and response rate of 93.43%. The overall magnitude of in hospital mortality was 7.42% [95% CI: 5.4- 9.8]. American society of anaesthesiology physiological status ? III [AOR=7.64 (95% CI:3.12-18.66)], systolic blood pressure <90mmHg at admission [AOR=6.11(95% CI:1.98-18.80)], presence of preoperative sepsis [AOR=3.54 (95% CI:1.53-8.19)], intensive care unit admission [AOR =4.75 (95% CI:1.50-14.96)] and overall length of hospital stay ?14 days [(AOR=6.76 (95% CI:2.50- 18.26)] were significantly associated with mortality after laparotomy. Concussion: In this study the overall in hospital mortality was high. Early identification of patients' American Society of Anaesthesiologists physical status, appropriate intervention and special attention is required for patients with: low systolic blood pressure, preoperative sepsis, intensive care unit admission and those prolonged hospital stay, to improve outcome of patients following laparotomy. Key words: In-hospital, Laparotomy, Magnitude, Mortality, Ethiopia