Outcomes in critical care delivery at Jimma University Specialised Hospital, Ethiopia
Outcomes in critical care delivery at Jimma University Specialised Hospital, Ethiopia
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DOI：
10.1177/0310057x1304100314
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发表时间：
2013-05-01
影响因子：
1.5
通讯作者：
McDonald, P.
中科院分区：
文献类型：
--
作者：
Smith, Z. A.;Ayele, Y.;McDonald, P.
本研究的目的是评估埃塞俄比亚吉玛大学专科医院重症监护室（ICU）入院后的结局。这是一项回顾性观察性研究。从2011年8月开始的12个月期间，收集了所有ICU入院和出院的数据。收集人口统计学数据和有关诊断、住院时间和结局的信息，并对数据进行分析。在研究期间，有370人入住ICU。中位年龄（四分位距）为32.0（22.0-47.0）岁，56.2%为男性。中位住院时间（四分位距）为3.0（1.0-7.0）天。ICU死亡率为50.4%，主要原因包括创伤、心脏病、急腹症、感染性休克、破伤风和继发于子宫破裂的子宫切除。内科诊断占入院人数的50.1%，其次是外科（43.2%）和产科（5.8%）。相应的死亡率分别为53.6%、48.0%和42.9%。手术治疗的主要原因是外伤，其中颅脑损伤的死亡率为52.1%。入院的主要原因是心脏病。在儿童中，创伤、上呼吸道阻塞和传染病最常见。埃塞俄比亚大学医院的重症监护死亡率反映了发展中国家重症监护服务面临的挑战。继发于难以获得医疗保健的延迟到医院就诊起着主要作用。这与人员配备、培训、诊断和干预限制不足有关。尽管资源有限，但简单的成本效益高的措施可能会降低发病率和死亡率。
The aim of this study was to assess outcomes following intensive care unit (ICU) admissions at Jimma University Specialised Hospital, Ethiopia. This was a retrospective observational study. Data were collected regarding all ICU admissions and discharges during a 12-month period beginning August 2011. Demographic data and information regarding diagnosis, length-of-stay and outcome were gathered and data analysed. There were 370 admissions to the ICU during the study period. Median age (interquartile range) was 32.0 (22.0-47.0) years and 56.2% were males. The median length-of-stay (interquartile range) was 3.0 (1.0-7.0) days. The overall ICU mortality rate was 50.4% and major causes included trauma, cardiac disease, acute abdominal presentations, septic shock, tetanus and hysterectomy secondary to uterine rupture. Medical diagnoses accounted for 50.1% of admissions followed by surgery (43.2%) and obstetrics (5.8%). Corresponding mortality rates were 53.6, 48.0 and 42.9%, respectively. The main cause for surgical admission was trauma, with head injury carrying a mortality of 52.1%. The principal cause for medical admission was cardiac disease. In children, trauma, upper airway obstruction and communicable diseases were most common. Critical care mortality rates at this Ethiopian university hospital reflect the challenges facing critical care delivery in the developing world. Delayed presentation to hospital secondary to poor access to healthcare plays a predominant role. This is confounded by inadequate staffing, training, diagnostic and interventional limitations. Despite resource restraints, simple cost-effective measures may improve morbidity and mortality.