The Pattern of Admission, Clinical Characteristics, and Outcomes Among Patients Admitted to the Intensive Care Unit of a Tertiary Hospital in Tanzania: A 5-Year Retrospective Review

Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the backgro...

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Vydáno v:Patient related outcome measures Ročník 14; s. 383 - 392
Hlavní autoři: Kassam, Nadeem, Adebayo, Philip, Matei, Iris, Aghan, Eric, Somji, Samina, Kadelya, Samwel, Abha, Yasson, Swai, Frank, Mabusi, Mangaro, Hameed, Kamran, Mbithe, Hanifa, Thawer, Alyyah, Makakala, Mandela, Bakshi, Fatma, Chuwa, Harrison, Ng'wanasayi, Masolwa, Wambura, Casmir, Mvungi, Robert, Orwa, James, Sharma, Munish, Udeani, George, Surani, Salim
Médium: Journal Article
Jazyk:angličtina
Vydáno: New Zealand Dove Medical Press Limited 31.12.2023
Dove
Dove Medical Press
Témata:
Communicable diseases
Comorbidity
critical care
Developing countries
epidemiological profile
Evidence-based medicine
Hospital patients
Medical records
Medical research
Medicine, Experimental
Mortality
Original Research
Patient outcomes
Septic shock
Sub-Saharan Africa
Tanzania
Sub-Saharan Africa
Tanzania
critical care
mortality
epidemiological profile
Tanzania
ISSN:1179-271X, 1179-271X
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Abstract Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery. A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and -value < 0.05) to identify the determinants for ICU mortality. Medical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96-6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU. The study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of Sub-Saharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multi-center studies are needed to highlight the true burden of critical care illness in Tanzania.
AbstractList Nadeem Kassam,1 Philip B Adebayo,1 Iris Martin Matei,1 Eric Aghan,2 Samina Somji,1 Samwel Paul Kadelya,1 Yasson Abha,1 Frank Elton Swai,2 Mangaro Mabusi,1 Kamran Hameed,1 Hanifa Mbithe,1 Alyyah Thawer,1 Mandela Charles Makakala,1 Fatma Amirali Bakshi,1 Harrison Chuwa,1 Masolwa Ng’wanasayi,1 Casmir M Wambura,1 Robert Sostenes Mvungi,1 James Orwa,3 Munish Sharma,4 George Udeani,5 Salim Surani5 1Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania; 2Department of Family Medicine, Aga Khan University Medical College, Nairobi, Kenya; 3Department of Population Health, Aga Khan University Medical College, Nairobi, Kenya; 4Department of Medicine, Division of Pulmonology and Critical Care, Baylor Scott and White Medical Center, Temple, Texas, USA; 5Department of Pharmacy, A&M University, College Station, Texas, USACorrespondence: Nadeem Kassam, Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania, Email Kassamnadeem2@gmail.comIntroduction: Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery.Material and Methods: A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients’ outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and p-value
Introduction: Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery. Material and Methods: A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality. Results: Medical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96- 6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU. Conclusion: The study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of SubSaharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multicenter studies are needed to highlight the true burden of critical care illness in Tanzania. Keywords: critical care, Tanzania, mortality, epidemiological profile
Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery.IntroductionDespite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery.A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality.Material and MethodsA single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality.Medical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96-6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU.ResultsMedical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96-6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU.The study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of Sub-Saharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multi-center studies are needed to highlight the true burden of critical care illness in Tanzania.ConclusionThe study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of Sub-Saharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multi-center studies are needed to highlight the true burden of critical care illness in Tanzania.
Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in Sub-Saharan Africa is more than ever before as the region experiences a double burden of rising rates of non-communicable diseases (NCD) in the background battle of combating infectious diseases. Limited studies in Tanzania have reported varying factors associated with markedly high rates of ICU mortality. Investigating the burden of ICU care remains crucial in providing insights into the effectiveness and challenges of critical care delivery. A single-center retrospective study that reviewed records of all medically admitted patients admitted to the ICU of the Aga Khan Hospital, Dar-es-Salaam, from 1st October 2018 to 30th April 2023. To define the population in the study, we used descriptive statistics. Patients' outcomes were categorized based on ICU survival. Binary logistic regression was run (at 95% CI and -value < 0.05) to identify the determinants for ICU mortality. Medical records of 717 patients were reviewed. The cohort was male (n=472,65.8%) and African predominant (n=471,65.7%) with a median age of 58 years (IQR 45.0-71.0). 17.9% of patients did not survive. The highest mortality was noted amongst patients with septic shock (29.3%). The lowest survival was noted amongst patients requiring three organ support (n=12,2.1%). Advanced age (OR 1.02,CI 1.00-1.04), having more than three underlying comorbidities (OR 2.50,CI 1.96-6.60), use of inotropic support (OR 3.58,CI 1.89-6.80) and mechanical ventilation (OR 9.11,CI 4.72-18.11) showed association with increased risk for mortality in ICU. The study indicated a much lower ICU mortality rate compared to similar studies conducted in other parts of Sub-Saharan Africa. Advanced age, underlying multiple comorbidities and organ support were associated with ICU mortality. Large multi-center studies are needed to highlight the true burden of critical care illness in Tanzania.
Audience Academic
Author Somji, Samina
Sharma, Munish
Surani, Salim
Abha, Yasson
Kassam, Nadeem
Aghan, Eric
Mabusi, Mangaro
Matei, Iris
Kadelya, Samwel
Makakala, Mandela
Udeani, George
Wambura, Casmir
Adebayo, Philip
Chuwa, Harrison
Mbithe, Hanifa
Ng'wanasayi, Masolwa
Hameed, Kamran
Orwa, James
Bakshi, Fatma
Mvungi, Robert
Swai, Frank
Thawer, Alyyah
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Keywords critical care
mortality
epidemiological profile
Tanzania
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2023 Kassam et al.
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Snippet Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care in...
Introduction: Despite the implementation of complex interventions, ICU mortality remains high and more so in developing countries. The demand for critical care...
Nadeem Kassam,1 Philip B Adebayo,1 Iris Martin Matei,1 Eric Aghan,2 Samina Somji,1 Samwel Paul Kadelya,1 Yasson Abha,1 Frank Elton Swai,2 Mangaro Mabusi,1...
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SubjectTerms Communicable diseases
Comorbidity
critical care
Developing countries
epidemiological profile
Evidence-based medicine
Hospital patients
Medical records
Medical research
Medicine, Experimental
Mortality
Original Research
Patient outcomes
Septic shock
Sub-Saharan Africa
Tanzania
Title The Pattern of Admission, Clinical Characteristics, and Outcomes Among Patients Admitted to the Intensive Care Unit of a Tertiary Hospital in Tanzania: A 5-Year Retrospective Review
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