article · Patient Related Outcome Measures
A five-year study analysed records of 546 medical patients admitted to an intensive care unit to determine factors linked to patient mortality in a resource-limited setting. The overall intensive care mortality rate reached 35.9 percent, with cardio-respiratory arrest identified as the leading immediate cause of death. Nearly half of the recorded deaths stemmed from septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. Statistical analysis identified multiple independent determinants of mortality, including the source of admission, Glasgow Coma Scale score at admission, duration of stay in the unit, inotrope administration, septic shock, and retroviral infection status. The findings indicate that early patient identification, prompt admission, and careful patient selection are critical strategies to address high mortality rates and allocate scarce critical care resources effectively.
Intensive care units in low-resource environments experience high death rates due to constrained clinical capacities. By detailing the clinical characteristics and specific conditions linked to poor patient survival, this research helps healthcare administrators and medical teams recognise the most vulnerable individuals early, refine admission criteria, and manage limited critical care resources more effectively.
The findings provide observational baseline data that could assist clinical software developers and healthcare administrators in designing early-triage algorithms and decision-support tools tailored for resource-limited emergency care. This represents early-stage clinical research, meaning any resulting digital protocols or triage tools would need to be formally developed, programmed, and tested in prospective clinical trials before adoption.
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Background: The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit. Methods: A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality. Results: The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality. Conclusion and Recommendations: This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.
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DOI: 10.2147/prom.s450502
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