Admission Pattern and Factors Associated with Treatment Outcome of Orthopedics Patients in Intensive Care Unit of Addis Ababa Burn Emergency and Trauma (AaBET) Hospital

Abstract

Background: Trauma is the main cause of death and disability worldwide. As a result of increased trauma burden, orthopedics patient  account for a considerable and growing proportion of patients in intensive care unit. Access to intensive care is an important part of the  health care system to reduce mortality and morbidity.

Objective: To assess admission patterns and factors associated with treatment outcomes of orthopedics patients in the ICU of Addis Ababa Burn Emergency and Trauma (AaBET) Hospital.

Method: The study employed analytical cross-sectional study design, reviewing ICU admissions of orthopedic patients from June 2017 to  November 2021. A total of 117 patients were included. Descriptive statistics such as mean, median, and standard deviation (SD) were used to summarize the demographic data and pattern of injury. Univariate and multivariate logistic regression analysis were applied to  assess the impact of various factors on the outcome variable and p-values < 0.05 were considered statistically significant.

Result: The  study included 117 orthopedic patients who had been admitted to the ICU, with a 6.3:1 male-to-female ratio. Traumatic causes of  admission accounted for 93.2% of the admissions. Road traffic accidents 88(75.2%) and fall-down accidents from a height 20 (17.1%) were  the two most common mechanisms of injury. Fracture was present in 109 (93.2%) patients. Apart from orthopedics conditions associated  medical, surgical, and neurosurgical conditions were present in 84(72.4%), 75(64.7%), and 74(63.8%)cases respectively. Respiratory failure  57 (48.7%) was the major reason for admission. The overall ICU mortality was 24 (20.5%). Factors associated with death outcome in the  ICU include GCS ≤8 (P=.045) (AOR=4.344, 95% CI; 1.106- 17.064), septic shock (P=.030) (AOR=10.495, 95% CI; 1.257, 87.630) and ICU length  ≤5 days (P=.015) (AOR=4.118, 95% CI; 1.306, 12.986).

Conclusion: Traumatic admission as a result of road traffic accident accounted for  the largest proportion of orthopedics patients to end up in AaBET ICU. To reduce the observed mortality, more emphasis should be given  for orthopedic patients with GCS ≤8, septic shock, and those within the first five days of admission.