ICU Mortality Patterns, Causes of Death, And Preventability at Nangarhar University Teaching Hospital Medical Ward, Afghanistan: A Retrospective Audit (2025–2026)

BACKGROUND: Intensive Care Unit (ICU) mortality remains a key indicator of healthcare quality and patient safety, particularly in resource-limited settings where shortages of personnel, equipment, and critical care resources may affect patient outcomes. Evaluating the causes of death and identifying potentially preventable factors are essential for improving the quality of care, optimising resource utilisation, and reducing mortality among critically ill patients OBJECTIVE: To analyse demographic patterns, causes of death, and preventability of ICU mortality. METHODS: A retrospective observational study of 70 ICU deaths was conducted. DATA INCLUDED 1. demographics, 2. diagnoses, 3. causes of death, 4. length of stay (LOS), 5. and preventability. 6. Descriptive statistics were used. RESULTS: Out of 826 inpatients during this year, 70(8.47%) patients died. Among the analysed subgroup of 70 patients, 55.7% were female, and sepsis was present in 57.1% of cases. Cardiopulmonary arrest (CPA) accounted for 80% of deaths, while 25.7% died within 24 hours of admission. Notably, 45.7% of deaths were considered possibly preventable. Major system gaps identified included delayed antibiotic administration (42.9%) and delayed ICU transfer (40%), indicating significant delays in time-sensitive critical care interventions. CONCLUSION: A substantial proportion of ICU deaths were preventable, primarily related to delays in recognition and management of sepsis. Early intervention strategies are essential.