30 day in-hospital patient mortality after ICU discharge and associated factors : a retrospective cohort study in selected tertiary hospitals in Kampala

Abstract

Background: Intensive care medicine is rapidly growing because critical illness is a major component of the global burden of disease especially in LMICs. We retrospectively evaluated the 30 day In-hospital patient mortality after ICU discharge and associated factors. Methods: We conducted a retrospective multicentre Cohort study on all patients that were discharged alive from the ICU at three tertiary hospitals in Kampala- Uganda, patient records discharged between January 2018 to December 2019 were reviewed during their hospital stay to fill the data extraction tool and followed up. In-hospital mortality after ICU discharge as primary outcome. Results: In total 711 patients were included with mean age of 42 years and 56.4% were male. A total of 106/711 patients died after ICU discharge giving a mortality of 14.9% (95% CI: 12.4-17.7). Most (86/711) patients died within the first 20 days with a 0.802 survival probability and were mostly above 40 years. The median number of hospital stay after ICU discharge 7 days (IQR: 5-11). Multivariate analysis identified presence of comorbidities, Respiratory disorder at ICU admission and GIT disorder at ICU admission and inotropic/vasopressor support to be associated with patient mortality after ICU discharge while Tracheostomy placement was found to be protective. Conclusion: The 30-day in hospital patient mortality rate after ICU discharge was high compared to that in high income countries. Most in-hospital patient deaths after ICU discharge occurred during the first 20 days. A prospective study is needed to further explore In-hospital patient mortality after ICU discharge and associated factors.