The burden on emergency centres to provide care for critically ill patients in Addis Ababa, Ethiopia
CCCF ePoster library. Debebe Yayehyirad F. 11/12/19; 285181; EP84
Finot Debebe Yayehyirad
Finot Debebe Yayehyirad
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Rate & Comment (0)
Topic: Survey or Interview (quantitative or qualitative)

Sultan Menbeua,  Mengistu Gelilaa,  DebebeFinotb, Azazh Aklilub,  TrehanIndi c,d
aDepartment of Emergency Medicine and Critical Care, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
bDepartment of Emergency Medicine and Critical Care, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
cLao Friends Hospital for Children, Luang Prabang, Lao Democratic People's Republic
dDepartment of Paediatrics, Washington University in St. Louis, Saint Louis, MO, United State

Introduction: Given the scarcity of critical care hospital beds in Africa, emergency centres (ECs) are increasingly charged with caring for critically ill patients for extended periods of time. The objective of this study was to improve the understanding of the nature and outcomes of critically ill patients with prolonged treatment times of more than six hours in two ECs in Addis Ababa, Ethiopia.
Objectives: The objective of this study is to describe the number, clinical characteristics, and outcomes of critically ill patients cared for in Emergency centers for more than six hours. This information is intended to provide more complete data on the burden of critically ill patients in ECs for use by hospital administrators, health care providers, and national policymakers.
Methods: This study was conducted over three months in two ECs of urban tertiary care hospitals in Addis Ababa. Structured questionnaires were completed by six emergency and critical care nurses. EC patients were included if they met the Society for Critical Care Medicine (SCCM) intensive care unit (ICU) admission criteria and stayed in the EC for more than 6 h. We collected initial demographic and clinical information, data about the patients' clinical course in the EC, and data regarding the patients' disposition. We used descriptive statistics for analysis.
Results: A total of 291 patients, over the course of three months, had an EC stay that exceeded six hours. The median length of stay for these patients was 48 h (interquartile range: 25–72 h). The most common categories of illness were neurological disease in 87 patients (30%) and cardiovascular disease in 61 patients (21%). The most frequent etiologies of critical illness were severe head trauma and severe sepsis with multi-organ failure (26 patients, 9% each). A total of 94 patients (32%) died in the EC, while 86 (30%) were discharged directly from the Emergency Cent without hospital admission.
Conclusion: Emergency Centers in Addis Ababa face a heavy burden in caring for a large number of critically ill patients over a long period of time, with relatively high mortality rates. These findings should promote supporting emergency centres to strengthen and expand ICU capacity to provide appropriate critical care service

1] Baelani I, Jochberger S, Laimer T, Otieno D, Kabutu J, Wilson I, et al. Availability of
critical care resources to treat patients with severe sepsis or septic shock in Africa: a
self-reported, continent-wide survey of anaesthesia providers. Crit Care
[2] Melaku Z, Alemayehu M, Oli K, Tizazu G. Pattern of admissions to the medical
intensive care unit of Addis Ababa University teaching hospital. Ethiop Med J
[3] LeDuc Media. Health profile Ethiopia,
country-health-profile/ethiopia; 2015 [accessed 25 November 2017].
[4] Chalya PL, Gilyoma JM, Dass RM, McHembe MD, Matasha M, Mabula JB, et al.
Trauma admissions to the intensive care unit at a reference hospital in northwestern
Tanzania. Scand J Trauma Resusc Emerg Med 2011;19:61.
[5] Green RS, MacIntyre JK. Critical care in the emergency department: an assessment
of the length of stay and invasive procedures performed on critically ill ed patients.
Scand J Trauma Resusc Emerg Med 2009;17:47.
[6] Taye BW, Yassin MO, Kebede ZT. Quality of emergency medical care in gondar
University referral hospital, northwest Ethiopia: a survey of patients' perspectives.
BMC Emerg Med 2014;14:2.
[7] Giday A, Weldeyes E. Trends in cardiovascular disease over time: a 30-year retrospective analysis of medical-ICU admissions in Addis Ababa, Ethiopia. Ethiop Med J
8] Adhikari NK, Fowler RA, Bhagwanjee S, Rubenfeld GD. Critical care and the global
burden of critical illness in adults. Lancet 2010;376(9749):1339–46.
[9] Weingart SD, Sherwin RL, Emlet LL, Tawil I, Mayglothling J, Rittenberger JC. ED
intensive care units. Am J Emerg Med 2013;31(3):617–20.
[10] Sultan Menbeu, Debebe Finot, Azazh Aklilu. The status of emergency medicine in
Ethiopia, challenges and opportunities. Ethiop Med J 2018;56(2):119–24.
[11] Task Force of the American College of Critical Care Medicine, Society of Critical
Care Medicine. Guidelines for intensive care unit admission, discharge, and triage.
Crit Care Med 1999;27(3):633–8.
[12] Cardoso LT, Grion CM, Matsuo T, Anami EH, Kauss IA, Seko L, et al. Impact of
delayed admission to intensive care units on mortality of critically ill patients: a
cohort study. Crit Care 2011;15(1):R28.
[13] Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP. group D-Es.
Impact of delayed transfer of critically ill patients from the emergency department
to the intensive care unit. Crit Care Med 2007;35(6):1477–83.
[14] Fromm Jr. RE, Gibbs LR, McCallum WG, Niziol C, Babcock JC, Gueler AC, et al.
Critical care in the emergency department: a time-based study. Crit Care Med
[15] Agalu A, Mirkuzie W, Ayele Y, Bedada W. Reasons for admission and mortalities
following admissions in the intensive care unit of a specialized hospital, Ethiopia.
Int J Med Med Sci 2014;6(9):195–200.
[16] Kedir S, Berhane A, Bayisa T, Wuletaw T. Admission patterns and outcomes in the
medical intensive care unit of st. Paul's hospital millennium medical college, Addis
Ababa, Ethiopia. Ethiop Med J 2017;55(1):19–26.
[17] SmithZA, Ayele Y, McDonald P. Outcomes in critical care delivery at Jimma
University Specialised Hospital, Ethiopia. Anaesth Intensive Care
[18] Poluyi EO, Fadiran OO, Poluyi CO, Alabi EO, Falohun SA. Profile of intensive care
unit admissions and outcomes in a tertiary care center of a developing country in
West Africa: a 5 year analysis. J Intens Crit Care 2016;2(3):2

    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Save Settings