Menbeu Sultan, MD, MPH
Associate Professor of Emergency Medicine and Critical Care
St Paul Hospital Millennium Medical Center, United States
Disclosure information not submitted.
Ayalew Zewdie, MD
Associate Professor of Emergency Medicine and Critical Care
Addis Ababa Burn, Emergency and Trauma Hospital, United States
Disclosure information not submitted.
Bhakti Hansoti, MD, PhD
Associate Professor of Emergency Medicine
Johns Hopkins University, United States
Disclosure information not submitted.
Sean Berenholtz, MD, MHS
Professor of Anesthesia and Critical Care Medicine
Johns Hopkins University, United States
Disclosure information not submitted.
William Checkley, MD, PhD
Associate Professor of Medicine
Johns Hopkins University, United States
Disclosure information not submitted.
Abi Beane, RN, PhD
Researcher
Mahidol Oxford Tropical Medicine Research Unit, United States
Disclosure information not submitted.
Rashan Haniffa, MBBS, PhD
Researcher
Mahidol Oxford Tropical Medicine Research Unit, United States
Disclosure information not submitted.
Title: Utilizing an Ethiopian ICU Registry to Identify Opportunities for Quality Improvement
Introduction: The global burden of critical illness disproportionally affects low- and middle-income countries (LMICs), and the outcomes of critical ill patients are significantly worse in those settings. Quality improvement efforts in LMICs are hampered by the lack of robust data about the burden of critical illness or the quality of care in LMIC ICUs. ICU registries are valuable tools that have been implemented in high-income countries to describe the case-mix, processes of care and clinical outcomes in ICUs, laying the groundwork for effective research and QI projects.
Methods: We implemented a novel, resource-appropriate ICU registry using an online platform developed by Crit Care Asia to collect data about the demographics, illness patterns, processes of care and clinical outcomes of critically ill patients admitted to two tertiary ICUs in Addis Ababa, Ethiopia. Clinical data were collected and inputted by specially trained data clerks. The first two months of patient data were extracted and analyzed descriptively.
Results: In June and July, 2021, 83 patients were admitted to the ICUs at St. Paul Hospital and Millennium Medical Center and the Addis Ababa Burn, Emergency and Trauma Hospital. Median age was 35 years (IQR 24-52) and 61% were male. 49% of patients were admitted post-operatively, with 68% of those following emergency surgery. On the day of ICU admission 77% required ventilator support and 17% required vasoactive support. Mean Apache II score was 24.1 (SD 4.1). By July 31, 47% of patients were transferred from the ICU alive, 33% had died in the ICU and 20% remained in the ICU. Standardized mortality ratio was 1.02. Mean length of stay (8.2 days) was similar for survivors and non-survivors.
Conclusions: This report demonstrates the feasibility of collecting surveillance data in Ethiopian ICUs using the Crit Care Asia platform, and the importance of ICU registries to understand ICU case-mix, processes of care and clinical outcomes in ICUs. These ICUs treat a high burden of critical illness. In this preliminary analysis, the high observed mortality rate is explained by the severity of illness being treated. Improving early recognition of critical illness and triage protocols may be important strategies to improve ICU survival.