Magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary public hospitals, West Oromia, Ethiopia, 2022

Abstract

Introduction: Laparotomy surgery is an incision in the abdominal cavity to treat serious abdominal disease and save the patient's life. It is performed in both elective and emergency conditions and results in significant deaths in both developed and developing countries, including Ethiopia. Studies of in-hospital mortality among patients undergone laparotomy surgery and associated factors are limited. Objective: To assess the magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary hospitals, West Oromia, Ethiopia, 2022. Method: An institutional retrospective cross-sectional study was donefrom January 1, 2017 to December 31, 2021. Data were collected using systematic random sampling and basedstructured and pre-tested abstraction sheet from 548 patient chars and registries.Data were checked for completeness, consistency, coded, importedusing EPI data version 4.6, cleaned and analyzedusing SPSS version 25. Variables with p < 0.2 in bi-variable logistic regression analysis were included in themultivariate logistic regression analysis. The model fitness was checked by the Hosmer-Lemeshow test. Using the adjusted odds ratio with 95% CI and a p-value of 0.05, statistical significance was declared. Results: A total of 512 patient records were reviewed and the response rate was 93.43%. The overall in-hospital mortality rate was 7.42% [95% CI: 5.4-9.8]. American Anaesthesiology Association physiological status of patients ≥ III [AOR=7.64 (95% CI: 3.12-18.66)], systolic blood pressure <90 mmHg at admission [AOR=6.11 (95% CI: 1.98-18.80)], presence of preoperative sepsis [AOR= 3.54 (95% CI: 1.53-8.19)], Intensive care unit admission [AOR = 4.75 (95% CI: 1.50-14.96)], and hospital stay ≥14 days [(AOR = 6.76 (95% CI: 2.50-18.26)] were significantly associated with in-hospital mortality after laparotomy surgery. Concussion: In this study,overall in-hospital mortality was high. TheAmerican Society of Anaesthesiologists identifies the patient's physical condition early, requires appropriate intervention,and pays special attention to patients: low systolic blood pressure, preoperative sepsis, admission to the hospital, Intensive care unit and prolonged hospital stay, in order to improve patient outcomes after laparotomy surgery.