Intensive care medicine in rural sub‐Saharan Africa
Summary We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%...
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| Veröffentlicht in: | Anaesthesia 2017-02, Vol.72 (2), p.181-189 |
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| creator | Dünser, M. W. Towey, R. M. Amito, J. Mer, M. |
| description | Summary
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001). |
| doi_str_mv | 10.1111/anae.13710 |
| format | Article |
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We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.13710</identifier><identifier>PMID: 27868190</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Africa ; Africa South of the Sahara ; Aged ; Aged, 80 and over ; Airway management ; Child ; Child, Preschool ; Critical Care ; epidemiology ; Female ; Hospital Mortality ; Humans ; Infant ; Infant, Newborn ; Intensive care ; intensive care medicine ; Intensive Care Units ; Male ; mechanical ventilation ; Middle Aged ; Mortality ; Patient Admission ; Traumatic brain injury ; Ventilators ; Young Adult</subject><ispartof>Anaesthesia, 2017-02, Vol.72 (2), p.181-189</ispartof><rights>2016 The Association of Anaesthetists of Great Britain and Ireland</rights><rights>2016 The Association of Anaesthetists of Great Britain and Ireland.</rights><rights>Copyright © 2017 The Association of Anaesthetists of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4260-2796f81a8747b6f95d057bbda29dd1b1d7868a40d895fcb2141a2a1898311d173</citedby><cites>FETCH-LOGICAL-c4260-2796f81a8747b6f95d057bbda29dd1b1d7868a40d895fcb2141a2a1898311d173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fanae.13710$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fanae.13710$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27868190$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dünser, M. W.</creatorcontrib><creatorcontrib>Towey, R. M.</creatorcontrib><creatorcontrib>Amito, J.</creatorcontrib><creatorcontrib>Mer, M.</creatorcontrib><title>Intensive care medicine in rural sub‐Saharan Africa</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).</description><subject>Adolescent</subject><subject>Adult</subject><subject>Africa</subject><subject>Africa South of the Sahara</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Airway management</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Critical Care</subject><subject>epidemiology</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>mechanical ventilation</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient Admission</subject><subject>Traumatic brain injury</subject><subject>Ventilators</subject><subject>Young Adult</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0L9OwzAQBnALgWgpLDwAisSCkFJ8juM_Y1QVqFTBAMzRJXFEqjQpNgF14xF4Rp4ElxQGBoSXW3736fwRcgx0DP5dYINmDJEEukOGEIk4ZJTzXTKklEYh41QPyIFzC0qBKVD7ZMCkEgo0HZJ41jybxlUvJsjRmmBpiiqvGhNUTWA7i3Xguuzj7f0OH9FiEySlrXI8JHsl1s4cbeeIPFxO7yfX4fz2ajZJ5mHOmaAhk1qUClBJLjNR6rigscyyApkuCsig2JyBnBZKx2WeMeCADEFpFQEUIKMROetzV7Z96ox7TpeVy01dY2PazqXg9yPGOWf_oJzFXAohPD39RRdtZxv_Ea9izQEiGnl13qvcts5ZU6YrWy3RrlOg6ab3dNN7-tW7xyfbyC7zFf7Q76I9gB68VrVZ_xGVJjfJtA_9BP9yilM</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Dünser, M. W.</creator><creator>Towey, R. M.</creator><creator>Amito, J.</creator><creator>Mer, M.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Intensive care medicine in rural sub‐Saharan Africa</title><author>Dünser, M. W. ; Towey, R. M. ; Amito, J. ; Mer, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4260-2796f81a8747b6f95d057bbda29dd1b1d7868a40d895fcb2141a2a1898311d173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Africa</topic><topic>Africa South of the Sahara</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Airway management</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Critical Care</topic><topic>epidemiology</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive care</topic><topic>intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>mechanical ventilation</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient Admission</topic><topic>Traumatic brain injury</topic><topic>Ventilators</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dünser, M. W.</creatorcontrib><creatorcontrib>Towey, R. M.</creatorcontrib><creatorcontrib>Amito, J.</creatorcontrib><creatorcontrib>Mer, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dünser, M. W.</au><au>Towey, R. M.</au><au>Amito, J.</au><au>Mer, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensive care medicine in rural sub‐Saharan Africa</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2017-02</date><risdate>2017</risdate><volume>72</volume><issue>2</issue><spage>181</spage><epage>189</epage><pages>181-189</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27868190</pmid><doi>10.1111/anae.13710</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Africa Africa South of the Sahara Aged Aged, 80 and over Airway management Child Child, Preschool Critical Care epidemiology Female Hospital Mortality Humans Infant Infant, Newborn Intensive care intensive care medicine Intensive Care Units Male mechanical ventilation Middle Aged Mortality Patient Admission Traumatic brain injury Ventilators Young Adult |
| title | Intensive care medicine in rural sub‐Saharan Africa |
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