scholarly journals A two-year review of adult emergency department mortality at Tikur Anbesa specialized tertiary hospital, Addis Ababa, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanna Daniel Yosha ◽  
Achamyelesh Tadele ◽  
Sisay Teklu ◽  
Kidest Getu Melese

Abstract Background Adult emergency department mortality remains high in resource-limited lower-income countries. The majority of deaths occur within the first 24 h of presentation to the emergency department. Many of these mortality’s can be alleviated with appropriate interventions. This study was aimed to assess the magnitude, cause, and factors related to very early mortality in patients presented to the emergency department of Tikur Anbesa Specialized Tertiary Hospital, Ethiopia from March 2018 to 2020. Methods This is a cross-sectional retrospective chart review. Retrospective data were collected from the records of all patients who died within 72 h of emergency department presentation from March 2018 to 2020. Data entered using Epi data 4.2.1 and analyzed using SPSS Version 23. Using the Chi-square test, binary and multiple logistic regression analysis were carried out to measure the association of variables of interest and very early emergency mortality. P-value < 0.05, odds ratio with 95% CI were used to identify the significant factors. Results Between March 2018 to 2020, 30,086 patients visited the ED and 604 patients died within 72 h of presentation (274 died within 24 h and 232 within > 24–72 h). Shock (36.7%) and road traffic accidents (3.16%) were the major causes of death. Triage category red AOR 0.23 95% CI 0.1–0.55 and duration of illness 4–24 h AOR 0.47 95% CI 0.26–0.87 were significantly associated with decreased very early emergency department mortality. Meanwhile, co-morbid disease HIV AIDS AOR 2.72 95% CI 1.01–7.30 and residence Addis Ababa AOR 2.78 95% CI 1.36–5.68 and Oromia AOR 3.23 95% CI 1.58–6.54 were found significantly associated with increased very early emergency department mortality. Conclusions and recommendations The mortality burden of a road traffic accident and shock in the TASTH is significant and the magnitude of ED mortality differs between these groups. Residence Addis Ababa and Oromia, triage category red, co-morbid disease HIV AIDS, and duration of symptom 4–24 h were significantly associated with early emergency department mortality. Early detection and intervention are required to minimize emergency mortality.

2021 ◽  
Author(s):  
Hanna Yosha ◽  
Achamyelesh Tadele ◽  
Sisay Teklu ◽  
Kidest Melese

Abstract Background: Adult emergency department mortality remains high in resource-limited lower-income countries. The majority of deaths occur within the first 72 hours of admission to the emergency department which is termed as early emergency department mortality. Many of these mortality’s can be alleviated with appropriate intervention. Though the magnitude, cause, and the time interval of death after their admission to the department have a huge aspect for the clinical world, however, studies on this topic lack adequate data. Therefore, this study was aimed to assess the magnitude, cause, and factors related to early mortality in patients presented to the emergency department of Tikure Anbesa Specialized Tertiary Hospital, Ethiopia from March 2018 to 2020. Methods: A retrospective cross-sectional study design was conducted to address the study objectives. Retrospective data were collected from the patients’ records who died in the emergency department from March 2018 to 2020. Data entered using Epi data 4.2.1 and analyzed using SPSS Version 23. Using the Chi-square test, binary and multiple logistic regression analyses were carried out to measure the association of variables of interest and the outcome variable (early emergency mortality). P-value < 0.05, odds ratio with 95% CI were used to identify the significant factors. Results: From the total identified emergency department death records, 506 (59.8) were early mortality. Triage category red AOR 0.23 95% CI 0.1-0.55, co-morbid disease HIV AIDS AOR 2.72 95% CI 1.01-7.30, residence Addis Ababa 2.78 (1.36-5.68) and Oromia 3.23 95% CI 1.58-6.54 and duration of illness 4-24 hour AOR 0.47 95% CI 0.26-0.87 were found significantly associated with early emergency department mortality. Conclusions and recommendations: The magnitude of early mortality was significant. Residence Addis Ababa and Oromia, triage category red, co-morbid disease HIV AIDS, and duration of symptom 4-24 hours were significantly associated with early emergency department mortality. Early detection and intervention are required to minimize emergency mortality.


2015 ◽  
Vol 30 (6) ◽  
pp. 599-605 ◽  
Author(s):  
Adam R. Aluisio ◽  
Annelies De Wulf ◽  
Ambert Louis ◽  
Christina Bloem

AbstractIntroductionMore than 90% of traumatic morbidity and mortality occurs in low- and middle-income countries (LMIC). Haiti is the poorest country in the Western Hemisphere and lacks contemporary statistics on the epidemiology of traumatic injuries. This study aimed to characterize the burden of traumatic injuries among emergency department patients in the Northeast region of Haiti.MethodsData were collected from the emergency departments of all public hospitals in the Northeast region of Haiti, which included the Fort Liberté, Ouanaminthe, and Trou du Nord sites. All patients presenting for emergent care of traumatic injuries were included. Data were obtained via review of emergency department registries and patient records from October 1, 2013 through November 30, 2013. Data on demographics, mechanisms of trauma, and anatomical regions of injury were gathered using a standardized tool and analyzed using descriptive statistics. Temporal analysis of injury frequency was explored using regression modeling.ResultsData from 383 patient encounters were accrued. Ouanaminthe Hospital treated the majority of emergent injuries (59.3%), followed by Fort Liberté (30.3%) and Trou du Nord (10.4%). The median age in years was 23 with 23.1% of patients being less than 15 years of age. Road traffic accidents (RTAs) and interpersonal violence accounted for 65.8% and 30.1% of all traumatic mechanisms, respectively. Extremity trauma was the most frequently observed anatomical region of injury (38.9%), followed by head and neck (30.3%) and facial (19.1%) injuries. Trauma due to RTA resulted in a single injury (83.8%) to either an extremity or the head and neck regions most frequently. A minority of patients had medical record documentation (37.9%). Blood pressure, respiratory rate, and mental status were documented in 19.3%, 4.1%, and 0.0% of records, respectively. There were 6.3 injuries/day during the data collection period with no correlation between the frequency of emergent trauma cases and day of the week (R^2=0.01).ConclusionsTraumatic injuries are a common emergent presentation in the Northeast region of Haiti with characteristics similar to other LMIC. Documentation and associated data to adequately characterize the burden of disease in this region are lacking. Road traffic accidents are the predominate mechanism of injury, suggesting that interventions addressing prevention and treatment of this common occurrence may provide public health benefits in this setting.AluisioAR,De WulfA,LouisA,BloemC.Epidemiology of traumatic injuries in the Northeast region of Haiti: a cross-sectional study.Prehosp Disaster Med.2015;30(6):599–605.


2021 ◽  
Vol 59 (243) ◽  
pp. 1081-1085
Author(s):  
Rohan Jha ◽  
Priya Pathak ◽  
Pallavi Koirala ◽  
Bishwash Maharjan ◽  
Srijana Panthi

Introduction: Road Traffic Accidents have emerged as the leading cause of mortality and morbidity globally. The burden of road traffic accidents has escalated gradually in Nepal and is a common cause of injury and trauma. The study aims to identify the prevalence of road traffic accidents in the emergency department. Methods: This descriptive cross-sectional study was conducted among hospital records of cases admitted to the emergency department of tertiary care hospital between March to August, 2020. Ethical approval was taken from the ethical review board of College of Medical Sciences (reference number: 2020-035). Information was collected through pro-forma and hospital records. Convenience sampling was done. The data were entered in the Statistical Package for the Social Sciences version 24 and analysed using descriptive statistics. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 4050 cases presenting to the emergency department, 228 (5.6%) (4.9-6.3 at 95% Confidence Interval) cases of road traffic accidents were seen. The most common injuries involved were soft tissue injury 90 (39.47%) and head injury 77 (33.77%). Most patients admitted to the hospital were male 178 (78.07%) aged 21 to 30 years 79 (41.38%). The vehicles mostly involved in the accidents were motorized two-wheelers 120 (50.6%) and pedestrians 51 (22.4%). Conclusions: The prevalence of road traffic accidents was similar to the findings from similar studies. Strengthening the capacities of the pre-hospital care and emergency department is necessary along with preventive intervention in public to reduce such health burden.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Bewket Tadesse Tiruneh ◽  
Berihun Assefa Dachew ◽  
Berhanu Boru Bifftu

Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa.Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance.Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13), conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84), financial problem (AOR = 9.91; 95% CI = 4.79–6.48), psychological problem (AOR = 17.58; 95% CI = 7.70–12.14), and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27) were independently associated with road traffic injury.Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended.


2018 ◽  
Vol 7 (1) ◽  
pp. 52
Author(s):  
Bayapa Reddy N. ◽  
Shakeer Kahn P. ◽  
Surendra Babu D. ◽  
Khadervali N. ◽  
Chandrasekhar C. ◽  
...  

2016 ◽  
Vol 6 (2) ◽  
pp. 66-71 ◽  
Author(s):  
S. Getachew ◽  
E. Ali ◽  
K. Tayler-Smith ◽  
B. Hedt-Gauthier ◽  
W. Silkondez ◽  
...  

2021 ◽  
Vol 8 (2) ◽  
pp. 105-111
Author(s):  
Sunil Adhikari ◽  
Suraj Rijal ◽  
Darlene Rose House

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.


Author(s):  
Arun Kumar Singh

Majority of the world's fatalities on the roads occur in low-income and middle-income countries, even though these countries have approximately half of the world's vehicles. India is no exception and data showed that more than 1.3 lakh people died on Indian roads, giving India the dubious honour of topping the global list of fatalities from road crashes. Road traffic injuries have been neglected from the global health agenda for many years, despite being predictable and largely preventable. Evidence from many countries shows that dramatic successes in preventing road traffic crashes can be achieved through concerted efforts that involve, but are not limited to, the health sector. Hence based on above findings the present study was planned for Assessment of Injuries in Road Traffic Accidents Admitted to Emergency Department of GMCH, Bettiah, West Champaran, Bihar. The present study was planned in Department of Forensic Medicine, Government Medical College, Bettiah, West Champaran, Bihar, India from jan 2018 to Dec 2018.In the present study 20 cases suffered from the road traffic accidents were evaluated for the pattern of injury. A predesigned and pretested questionnaire especially designed for this purpose was used for interviewing the accident victims, either in the emergency itself or in the wards. In India, there are ample risk factors for RTAs to occur because of lack of proper infrastructural facilities, poor designs of roads, improper implementation of traffic rules and a high load of variety of vehicles on the roads.  Road traffic accidents with head injuries are much more common in young working males as compared to females and that to in those who were pedestrians and motor cyclists. The rate of incidence is higher in India because of bad traffic patterns and possibly the lack of awareness about traffic rules and also lack of good hospital services to our victims of RTAs. Keywords: Injuries, Road Traffic Accidents, Emergency Department, GMCH, Bettiah, West Champaran, Bihar, etc.  


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