Prevalence of Mortality and Associated Factors in the Adult Intensive Care Unit of a Private Hospital in Addis Ababa, Ethiopia

Abstract

ABSTRACT

Background: The intensive care unit (ICU) provides specialized care for life-threatening conditions. Critical care remains challenging in developing countries, where health needs exceed resources. ICU mortality in Ethiopia is higher than in developed nations, but data from private-hospital ICUs are lacking. This study assessed mortality prevalence and associated factors among adult ICU patients at a private hospital in Addis Ababa, Ethiopia.

Methods: A retrospective cross-sectional study evaluated 366 adult ICU patients selected via simple random sampling from registers at Myungsung Christian Medical Center (MCMC) from January 2018 to December 2019. Data collected via a structured, pre-tested checklist were entered into Epi Info and exported to SPSS. Bivariable and multivariable logistic regressions identified mortality predictors, with model fit assessed using the Hosmer–Lemeshow test. Ethical approval was granted by Addis Ababa University College of Health Sciences' Department of Emergency Medicine and Critical Care.

Results: Of 366 patients, 220 (60.1%) were male and 119 (32.5%) were >60 years (mean age: 50.4 ± 19.18 years). Sepsis (chest or urinary focus) was the primary admission diagnosis (24.3%), followed by surgical conditions (19.4%) and stroke (16.1%). Mechanical ventilation and vasopressors were required by 46.7% and 22.1% of patients, respectively. Overall, 105 patients (29%) died; cardiac arrest caused 31.4% of deaths, and 60% occurred during duty (off-hours) time. On multivariable regression, age >60 years, shock, mechanical ventilation, infection on admission, vasopressor use, and impaired consciousness (GCS ≤8) were independently associated with mortality (p<0.05).

Conclusion: Private-hospital ICU mortality in Addis Ababa was lower than in Ethiopian public hospitals but remains higher than in developed countries. Older age, shock, mechanical ventilation, vasopressors, admission infection, and impaired consciousness independently predicted mortality, highlighting targets for protocol-driven sepsis and ventilator management.

Keywords: Intensive care unit; mortality; associated factors; private hospital; Ethiopia.