Implementing an ICU registry in Ethiopia-Implications for critical care quality improvement.

Africa Complications Critical care ICU registry Intensive care unit Low- and middle-income countries Outcomes research Quality improvement Resource-limited setting

Journal

Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642

Informations de publication

Date de publication:
17 Jan 2024
Historique:
received: 26 09 2023
revised: 02 01 2024
accepted: 04 01 2024
medline: 18 1 2024
pubmed: 18 1 2024
entrez: 18 1 2024
Statut: aheadofprint

Résumé

Intensive care units (ICUs) in low- and middle-income countries have high mortality rates, and clinical data are needed to guide quality improvement (QI) efforts. This study utilizes data from a validated ICU registry specially developed for resource-limited settings to identify evidence-based QI priorities for ICUs in Ethiopia. A retrospective cohort analysis of data from two tertiary referral hospital ICUs in Addis Ababa, Ethiopia from July 2021-June 2022 was conducted to describe casemix, complications and outcomes and identify features associated with ICU mortality. Among 496 patients, ICU mortality was 35.3%. The most common reasons for ICU admission were respiratory failure (24.0%), major head injury (17.5%) and sepsis/septic shock (13.3%). Complications occurred in 41.0% of patients. ICU mortality was higher among patients with respiratory failure (46.2%), sepsis (66.7%) and vasopressor requirements (70.5%), those admitted from the hospital ward (64.7%), and those experiencing major complications in the ICU (62.3%). In this study, ICU mortality was high, and complications were common and associated with increased mortality. ICU registries are invaluable tools to understand local casemix and clinical outcomes, especially in resource-limited settings. These findings provide a foundation for QI efforts and a baseline to evaluate their impact.

Identifiants

pubmed: 38237203
pii: S0883-9441(24)00012-1
doi: 10.1016/j.jcrc.2024.154525
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

154525

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Menbeu Sultan (M)

St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia.

Ayalew Zewdie (A)

St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia; Addis Ababa Burn, Emergency and Trauma Hospital, Addis Ababa, Ethiopia.

Dilanthi Priyadarshani (D)

Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka. Electronic address: dilanthi@nicslk.com.

Ephrem Hassen (E)

St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia.

Melkamu Tilahun (M)

St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia.

Tigist Geremew (T)

Addis Ababa Burn, Emergency and Trauma Hospital, Addis Ababa, Ethiopia.

Abi Beane (A)

Centre for Inflammation Research, University of Edinburgh, Scotland, UK. Electronic address: abi@nicslk.com.

Rashan Haniffa (R)

Centre for Inflammation Research, University of Edinburgh, Scotland, UK. Electronic address: rashan@nicslk.com.

Sean M Berenholtz (SM)

Johns Hopkins University School of Medicine, Department of Anesthesia and Critical Care Medicine, Baltimore, MD, USA. Electronic address: sberenho@jhmi.edu.

William Checkley (W)

Johns Hopkins University School of Medicine, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD, USA. Electronic address: wcheck1@jhmi.edu.

Bhakti Hansoti (B)

Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, MD, USA. Electronic address: bhansot1@jhmi.edu.

Adam D Laytin (AD)

Johns Hopkins University School of Medicine, Department of Anesthesia and Critical Care Medicine, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, MD, USA. Electronic address: alaytin1@jhmi.edu.

Classifications MeSH