A cross sectional survey of factors influencing mortality in Rwandan surgical patients in the intensive care unit.

Abstract

Management of critically ill patients is a challenge in low resource settings where there is a paucity of trained staff, infrastructure, resources, and drugs. We aimed to study the characteristics of surgical patients admitted in intensive care unit in a limited resource setting and determine factors associated with mortality. This was a cross-sectional observational study of all surgical patients admitted to the intensive care unit of a tertiary referral hospital in Rwanda. Data included demographics, diagnosis, management, and outcomes. Logistic regression was used to determine factors associated with mortality. Over a 7-month period, there were 126 surgical patients admitted to the intensive care unit. Common diagnoses included head injury (n = 55, 44%), peritonitis (n = 33, 26%), brain tumor (n = 15, 12%), and trauma (n = 15, 12%). The overall mortality was 47% with the highest mortality seen in patients with peritonitis (76%). Factors associated with mortality on intensive care unit admission included hypotension (odds ratio, 12.50; 95% confidence interval, 3.04, 51.32) and having any comorbidity (odds ratio 5.69, 95% confidence interval, 1.58, 20.50). Surgical patients admitted to the intensive care unit bear a significant mortality. Common surgical intensive care unit diagnoses include head injury and peritonitis. We recommend a review of the admission policy to optimize utility of the intensive care unit.