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.

Tanzania critical care epidemiological profile mortality

Journal

Patient related outcome measures
ISSN: 1179-271X
Titre abrégé: Patient Relat Outcome Meas
Pays: New Zealand
ID NLM: 101551170

Informations de publication

Date de publication:
2023
Historique:
received: 26 10 2023
accepted: 18 11 2023
medline: 13 12 2023
pubmed: 13 12 2023
entrez: 13 12 2023
Statut: epublish

Résumé

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 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.

Identifiants

pubmed: 38089710
doi: 10.2147/PROM.S441293
pii: 441293
pmc: PMC10712334
doi:

Types de publication

Journal Article

Langues

eng

Pagination

383-392

Informations de copyright

© 2023 Kassam et al.

Déclaration de conflit d'intérêts

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Auteurs

Nadeem Kassam (N)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Philip B Adebayo (PB)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Iris Martin Matei (IM)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Eric Aghan (E)

Department of Family Medicine, Aga Khan University Medical College, Nairobi, Kenya.

Samina Somji (S)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Samwel Paul Kadelya (SP)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Yasson Abha (Y)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Frank Elton Swai (FE)

Department of Family Medicine, Aga Khan University Medical College, Nairobi, Kenya.

Mangaro Mabusi (M)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Kamran Hameed (K)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Hanifa Mbithe (H)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Alyyah Thawer (A)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Mandela Charles Makakala (MC)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Fatma Amirali Bakshi (FA)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Harrison Chuwa (H)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Masolwa Ng'wanasayi (M)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Casmir M Wambura (CM)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

Robert Sostenes Mvungi (RS)

Department of Internal Medicine, Aga Khan Health Service, Dar-es-Salaam, Tanzania.

James Orwa (J)

Department of Population Health, Aga Khan University Medical College, Nairobi, Kenya.

Munish Sharma (M)

Department of Medicine, Division of Pulmonology and Critical Care, Baylor Scott and White Medical Center, Temple, Texas, USA.

George Udeani (G)

Department of Pharmacy, A&M University, College Station, Texas, USA.

Salim Surani (S)

Department of Pharmacy, A&M University, College Station, Texas, USA.

Classifications MeSH