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IntroductionCritical care is a serious global healthcare burden. Although a high number of surgical patients are being admitted to the surgical intensive care unit (SICU), the mortality remained high, particularly in low and middle-income countries. However, there is limited data in Ethiopia. Therefore, this study aimed to investigate the survival status and predictors of mortality in surgical patients admitted to the SICUs of Addis Ababa governmental hospitals, Ethiopia.MethodsA multicenter retrospective cohort study was conducted on 410 surgical patients admitted to the SICUs of three government hospitals in Addis Ababa selected using a simple random sampling from February 2017 to February 2020. The data were entered into Epidata version 4.6 and imported to STATA/MP version 16 for further analysis. Bi-variable and multivariable Cox regression models were fitted in the analysis to determine the predictor variables. A hazard ratio (HR) with a 95% confidence interval (CI) was computed, and variables with a p-value <0.05 were considered statistically significant.ResultsFrom a sample of 410 patients, 378 were included for final analysis and followed for a median follow-up of 5 days. The overall mortality among surgical patients in the SICU was 44.97% with an incidence rate of 5.9 cases per 100 person-day observation. Trauma (AHR = 1.83, 95% CI: 1.19–2.08), Glasgow coma score (GCS) <9 (AHR = 2.06, 95% CI: 1.28–3.31), readmission to the SICU (AHR = 3.52, 95% CI: 2.18–5.68), mechanical ventilation (AHR = 2.52, 95% CI: 1.23–5.15), and creatinine level (AHR = 1.09, 95% CI: 1.01–1.18) were found to be significantly associated with mortality in the SICU.ConclusionThe mortality of surgical patients in the SICU was high. Trauma, GCS <9 upon admission, readmission to the SICU, mechanical ventilation, and increased in the creatinine level on admission to the SICU were the identified predictors of mortality in the SICU.

ObjectiveThis study aimed to assess the incidence and identify predictors of perioperative mortality among the adult age group at Tibebe Ghion Specialised Hospital.DesignA single-centre prospective follow-up study.SettingA tertiary hospital in North West Ethiopia.ParticipantsWe enrolled 2530 participants who underwent surgery in the current study. All adults aged 18 and above were included except those with no telephone.Primary outcome measuresThe primary outcome was time to death measured in days from immediate postoperative time up to the 28th day following surgery.ResultA total of 2530 surgical cases were followed for 67 145 person-days. There were 92 deaths, with an incidence rate of 1.37 (95% CI 1.11 to 1.68) deaths per 1000 person-day observations. Regional anaesthesia was significantly associated with lower postoperative mortality (adjusted hazard ratio (AHR) 0.18, 95% CI 0.05 to 0.62). Patients aged ≥65 years (AHR 3.04, 95% CI 1.65 to 5.75), American Society of Anesthesiologist (ASA) physical status III (AHR 2.41, 95% CI 1.1.13 to 5.16) and IV (AHR 2.74, 95% CI 1.08 to 6.92), emergency surgery (AHR 1.85, 95% CI 1.02 to 3.36) and preoperative oxygen saturation <95% (AHR 3.14, 95% CI 1.85 to 5.33) were significantly associated with a higher risk of postoperative mortality.ConclusionThe postoperative mortality rate at Tibebe Ghion Specialised Hospital was high. Age ≥65, ASA physical status III and IV, emergency surgery, and preoperative oxygen saturation <95% were significant predictors of postoperative mortality. Patients with the identified predictors should be offered targeted treatment.

Background Acute pain is a predominant problem in the prehospital setting. Acute pain management in the prehospital setting requires precise and competent skills in practice—failure to assess and relieve pain results in multisystem effects that lead to poor patient prognosis. Emergency care providers should have adequate knowledge and develop good pain management practices. Limited information is documented on knowledge, attitude and practices about acute pain management among emergency care providers. This study aimed to assess the Knowledge, Attitude, and Practice of acute pain management in the prehospital setting and associated factors among emergency care providers in Addis Ababa, Ethiopia. Methods Quantitative cross-sectional study design was conducted among emergency care providers working in a prehospital setting in Addis Ababa, Ethiopia. One hundred forty-one participants were included in the study. Data were collected using a structured questionnaire and practice observation checklist, then entered into Epi-info version 7 and exported to SPSS version 25 for further analysis using a logistic regression model. Results Most participants had good knowledge, with 81 (63.8%) scoring above the mean value (64%). The mean percentage for pain management practice was 36%. Availability of pain medications and assessment for pain were factors significantly associated with pain management practice with an adjusted odds ratio of 7.98, 95% CI: 1.32–48.18 and 42.87, 95% CI: 12.7-144.7, respectively. Conclusion The results show that the knowledge regarding acute pain management is good, but the attitude and practice of emergency care providers are unfavourable and poor. Further research is indicated to assess the possible barriers and facilitators of acute pain management in the prehospital setting.