Intensive Care Outcomes and Mortality Prediction at a National Referral Hospital in Western Kenya

Abstract

In a Kenyan public ICU, high mortality was noted despite the use of advanced therapies. MPM-II has acceptable discrimination but poor calibration. Modification of MPM-II or development of a new model using a prospective multicenter global collaboration is needed. Standardized triage and treatment protocols for high-risk diagnoses are needed to improve ICU outcomes.

Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

“…The commonest causes of ICU admissions in our study were cardiovascular and respiratory disorders which are comparable with studies conducted globally [2,6,20,28,32,45,48,49,52,53,56,58]. However, there are discrepancies on the causes of admission to intensive care unit where studies conducted in Kenya, Tanzania, Uganda, Nigeria revealed postoperative events were the major causes of Admission [38,41,54] while studies were done from Jimma University referral hospital and Addis Ababa Black Lion hospital was due to trauma [46,53]. An international study from six continents including 10069 patients and another study from Belgium and the UK showed that the major causes of admission were cardiovascular and respiratory disease [20,40,45].…”

“…The data was collected by three trained bachelors Anesthetist with standardized questionnaire adapted from previous literature [28,32,36,41,44,49,50,[54][55][56]. A total of 524 patient charts were recruited from 2119 patients admitted in ICU from June 20, 2018, to 2020 in three hospitals with systematic allocation proportion based on the number of patients admitted during the study period (Fig 1).…”

Admission pattern, Clinical outcome and associated factors among patients admitted in medical intensive care unit at University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia, 2019. A retrospective cross-sectional study.

“…This study revealed that need for mechanical ventilation is independent risk factor of ICU mortality with (AOR: 5.578, P<0.001) which was similar with the studies done in Kenya and Brazil (AOR= 10.7, p<0.001) and (AOR: 6.37, p<0.001) respectively (21,22). The possible explanation for this association could be related that mechanical ventilators initiated for the patients with respiratory failure, unable to protect the airway and hemodynamic instability.…”

“…In the current study, the median length of ICU stay found to be 4 days which is similar to the other African countries (9,16). Out of 504 patients, 118(23%) where stayed in ICU 24 hours or less and 89 (75%) of patients died.…”

“…In Africa, the ICU mortality rate is high as it compared to the other developed continents. The mortality rate in Nigeria, Uganda, Tanzania, and Kenya were 32.9%, 40.1%, 41.1%, and 53.6% respectively (6)(7)(8)(9). In Ethiopia, different studies showed that the mortality rate is relatively similar to other Africa countries.…”