“Survival status and predictors of mortality among adult trauma patients admitted to intensive care unit of governmental hospitals in Addis Ababa, Ethiopia 2022/23: an institution based multicenter retrospective cohort study.” for your consideration

Background: Trauma has become an international concern due to millions of deaths. Mortality among trauma patients in intensive care units (ICU) remained high, especially in low and middle-income countries. Up to 50% of the trauma patients die in ICUs in Ethiopia. There is Limited information on the timing component of mortality and predictors of mortality are missed in previous studies. Hence this study was designed to investigate the survival status of trauma patients in the ICU and its predictors. Objective: To estimate the survival status and predictors of mortality among trauma patients admitted to intensive care units of selected governmental hospitals in Addis Ababa. Methods: A retrospective cohort study was conducted on 351 trauma patients admitted to intensive care units of purposively selected three government hospitals in Addis Ababa. Before being imported into STATA/MP version 17 for additional analysis, the data was first entered into Epidata version 3.1. To determine the predictor variables, bi-variable and multivariable Cox regression models were fitted in the analysis. A 95% confidence interval of hazard ratio (HR) was computed, and variables with a p-value of less than 0.05 in the multivariable model were considered to be significantly associated with the dependent variable. Result A total of 351 trauma patients were followed retrospectively, median follow-up of 8 days. Out of all 106 (30.2%), deaths were recorded with an incidence rate of 2.3 cases per 100 person-day observation. The cumulative probability of death in the intensive care unit was 0.7842 in a total of 4550.6 person day observations. Creatinine level >1.3 mg/dl, Glasgow coma score (GCS) below 9, a complication in ICU, vasoactive, hypoxia upon admission, and heart rate <60 and >100 (beat per minute bpm) found to be significantly associated with mortality trauma patients in ICU. Conclusion and recommendation: Mortality among trauma patients in the ICU was high, despite the expected national goal of 73 per 100,000 population in 2022. GCS below 9, vasoactive requirement, and increased creatinine level were some of the predictors for ICU mortality. Therefore, giving special attention to the above predictor factors is crucial.