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

Abstract

Abstract Background: Trauma is a leading cause of death and disability worldwide. It is the most frequent cause of death in the first four decades of life, and it remains a major public health problem in every country. Access to critical care is crucial component of health care system hence critically ill patients are admitted to the ICU to reduce mortality and morbidity The aim of this study is to assess the admission pattern and factors associated with treatment outcome of orthopedics patients in Intensive care unit of Addis Ababa Burn Emergency and Trauma Hospital (AaBET) Hospital. Method: The study was conducted in Intensive Care Unit of Addis Ababa Burn Emergency and Trauma Hospital (AaBET) from January 1, 2022 to February 28,2022. The Study utilized a retrospective cross-sectional design by reviewing data on available medical records, over a period of four and half years. A total of 117 patients medical record with orthopedic condition and treated in Intensive Care Unit was included in the study. The data was collected using structured questionnaire, then entered and analyzed using SPSS version 25. Logistic regression (binary and multiple) analyses were used to determine the effect of factor(s) on the outcome variable. Result: A total of 117 ICU admitted orthopedics patient were studied with the male to female ratio of 6.3:1. More than half (57.3%) of the patients were between age of 20 to 39. Traumatic cause of admission accounted for 93.2% of the admission. Road traffic accident 88(75.2%) and fall down accident from a height 20 (17.1%) were the two most common mechanism of injury. Fracture was present in 109 (93.2%) patients, the common anatomic area being lower limb followed by upper limb. Apart from orthopedics condition associated medical, surgical and neurosurgical condition was present in 84(72.4%), 75(64.7%) and 74(63.8%)cases respectively. Respiratory failure 57 (48.7%) was the major reason of admission. The mean length of stay in ICU was 14.9 (SD=10.069). The overall in ICU mortality was 24 (20.5%). Factors associated with outcome of patients in ICU were GCS ≤8 (P=.045) (AOR=4.344, 95% CI; 1.106-17.064), septic shock (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 RTA accounted for the largest proportion of orthopedics patient to end up in AaBET ICU. More than half of the patients were young and in their productive age year. Efforts should be made at reducing the occurrence of road traffic accidents to reduce morbidity. Emphasis made on orthopedics patients who have GCS ≤8, Septic shock and those in their initial 5 days of admission; will help improve the outcome of patients. Keyword: Orthopedics, Intensive Care Unit, Critical Care, Admission pattern, Outcome