ABSTRACT
Unplanned postoperative critical care admission poses a potential risk to patients and places unanticipated pressure on clinical services and it has become an important parameter to assess patient safety in perioperative services. This study was aimed to determine the incidence of unplanned intensive care unit admission following surgery and the associated factors. A multi-center cross-sectional study was conducted on postoperative patients admitted to the ICU of three hospitals located in the Amhara region. Data were collected via a structured survey tool and analyzed using SPSS version 23 software with binary logistic regression analysis. The statistical significance to identify patient, anesthetic and surgical related factors in the preoperative, intraoperative, and postoperative period was < 0.05 for multivariable regression with a 95% confidence interval. Predominantly patients were admitted to the ICU in an unplanned manner. ASA status, preoperative hemoglobin (Hgb) level, intraoperative estimated blood loss, and adverse events occurring in the operating room were significantly associated with intensive care unit admission following surgery. Patients who had a low preoperative Hgb value were 35.1 times more likely to be admitted to the intensive care unit in an unplanned manner compared with their counterparts [(Adjust odds ratio (AOR) 35.16; CI 12.82, 96.44)]. Patients with ASA II and III were 19.4 and 16.2 times more likely to be admitted to ICU in an unplanned way compared to patients who had ASA I physical status [(AOR 51.79; CI 8.28, 323.94) (AOR 67.8 CI 14.68, 313.53)]. Unplanned ICU admission after surgery was high in this study, suggesting poor perioperative planning, risk stratification, and optimization of patients.
Subject(s)
Hospitals, State , Intensive Care Units , Humans , Incidence , Cross-Sectional Studies , EthiopiaABSTRACT
Background: Coronavirus disease is still a global public health emergency. Due to an inadequate healthcare system in low-income nations like Ethiopia, the pandemic has had a devastating impact. Despite this, information on the severity of COVID-19 and related difficulties in Ethiopia is sparse. Therefore, we aimed to determine the survival time to severity and predictors of COVID-19 in Northwest Ethiopia. Methods: A prospective follow-up study was conducted among 202 adult COVID-19 patients in the South Gondar zone treatment centers. Data were entered using EpiData version 3.1 and then exported to Stata 16 for analysis. Kaplan-Meier was used to estimate mean survival time, and Log rank tests were used to compare survival time between explanatory variable groups. A cox-proportional hazards regression model with a 95% confidence interval and a p-value of 0.05 was used to identify covariates associated with the outcome variable. Results: The patients' average age was 41.2 years. With an IQR of 4-7 days, the median time to COVID-19 severity was 5 days. The overall COVID-19 severity rate was 6.35 (95% CI: 5.17-7.86) per 100 person-days observed. Senior adult age group (51-59 years) (AHR = 3.59, 95% CI: 1.05, 12.23), elderly age group (≥60 years) (AHR = 2.11, 95% CI: 1.09, 12.67), comorbidity (AHR = 3.26, 95% CI: 1.48, 7.18), high blood pressure at admission (AHR = 4.36, 95% CI: 1.99, 9.54), and high temperature at admission (AHR = 5.60, 95% CI: 2.55, 12.46) were significantly associated with COVID-19 severity time. Conclusion and Recommendation: Patients with COVID-19 had a short median severity time, and factors like older age, comorbidity, high temperature, and high blood pressure were all independent predictors of severity time. Patients with high body temperature, blood pressure, comorbidity, and advanced age should be the focus of interventions to reduce progression time and improve clinical outcomes.
ABSTRACT
BACKGROUND: Despite the higher mortality rate of breast cancer in low and middle-income countries, the practice of early detection methods is low and the majority of the patients presenting at an advanced stage of the disease need palliative care with low survival rates. Although healthcare providers are the key for practicing early detection methods of breast cancer for themselves and their clients, little is known about their knowledge and practice of early detection methods of breast cancer in Northcentral Ethiopia. METHODS: An institution-based cross-sectional study was conducted among female healthcare providers at Debre Tabor Comprehensive Specialised Hospital. Data were collected using a structured self-administered questionnaire. The data were analysed using SPSS version 23. Descriptive statistics were used to describe the socio-demographic information of participants. Binary and multivariable logistic regression with adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was declared at p < 0.05. RESULT: The mean (±SD) age of the participants was 31.4 (±7.8) years. About 106 (79.7%) participants had good knowledge about breast cancer early detection methods and only 56 (42.1%) of them practiced breast self-examination regularly. Work experience of >2 years (AOR = 3.2; 95% CI: 1.72, 5.29), history of any breast problem (AOR = 1.4; 95% CI: 1.02, 2.37), family history of breast cancer (AOR = 4.0; 95% CI: 2.58, 15.84), having good knowledge (AOR = 2.9; 95% CI: 1.3, 6.52) and history of comorbidities (AOR = 1.09; 95% CI: 1.09, 3.59) were the factors associated with the practice of breast self-examination. CONCLUSION: Our study found that the knowledge and practice of breast cancer early detection methods was low in the study setting. Only less than half of female healthcare providers practiced regular breast self-examination, which suggests the need to provide training for healthcare providers to fill the gap and to promote early detection of breast cancer cases.
