Mortality and its predictors among neurosurgical patients admitted to the surgical ICU in a resource-limited setting: experience from Ethiopia.

Abstract

Neurosurgical patients frequently require intensive postoperative care. However, data on the factors influencing their outcomes in low-resource environments are limited. This study aimed to identify the predictors of mortality among neurosurgical patients admitted to the Surgical Intensive Care Unit at the Tikur Anbessa Specialized Hospital, Ethiopia. A retrospective cohort study was conducted between January 1, 2024, and January 1, 2025. All neurosurgical patients admitted to the surgical Intensive Care during the study period were reviewed. Patient outcomes were categorized as death during Intensive Care Unit stay or discharge or transfer with clinical improvement. Multivariate logistic regression analysis was performed using SPSS version 27, and variables with p < 0.05 were considered statistically significant. A total of 140 neurosurgical patients were included, with an overall ICU mortality rate of 23% (n = 32). Emergency surgery (AOR = 7.4; 95% CI: 1.26-13.97; p = 0.027), intraoperative blood loss > 1000 mL (AOR = 4.0; 95% CI: 1.96-5.29; p = 0.044), lack of continuous postoperative monitoring (AOR = 3.5; 95% CI: 1.93-13.15; p = 0.044), and ICU complications (AOR = 7.8; 95% CI: 1.92-13.49; p = 0.004) were independently associated with increased mortality. 23% Of the neurosurgical patients admitted to the SICU died during the ICU stay. Mortality was independently associated with emergency surgery, significant intraoperative blood loss, lack of continuous postoperative monitoring, and the occurrence of ICU-related complications.