Incidence of mortality and predictors among patients with shock managed in the emergency room of a tertiary hospital in Ethiopia

Authors

Kalsidagn Girma Asfaw, Department of Emergency Medicine and Critical Care, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
Abel Getachew Adugna, Ethio Scandic Internal Medicine Specialty Clinic, Addis Ababa, Ethiopia.
Nahom Mesfin Mekonen, Department of Emergency Medicine and Critical Care, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
Merahi Kefyalew Merahi, Department of Emergency Medicine and Critical Care, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
Segni Kejela, Department of Surgery, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Fekadesilassie Henok Moges, Advocate Health - MidwestFollow
Tigist Workneh Leulseged, Medical Research Lounge (MRL), Addis Ababa, Ethiopia.

Recommended Citation

Asfaw KG, Adugna AG, Mekonen NM, et al. Incidence of mortality and predictors among patients with shock managed in the emergency room of a tertiary hospital in Ethiopia. Afr J Emerg Med. 2025;15(4):100917. doi:10.1016/j.afjem.2025.100917

Affiliations

Aurora West Allis Medical Center

Abstract

Introduction: Shock is a common emergency condition which can lead to organ failure and death if not diagnosed and managed timely. Despite its huge global impact, data is scarce in resource-limited settings, including Ethiopia, which hinders the provision of quality care for improved outcomes. Hence, this study aimed to determine the incidence of death and predictors among adult patients with shock managed at the Emergency Department of St. Paul's Hospital Millennium Medical College in Ethiopia.

Methods: A retrospective chart review study was conducted among eligible patients managed at the hospital between October 1, 2021 and May 20, 2022. Mortality was estimated with incidence density using person day (PD) of observation. To identify predictors of mortality, a generalized linear model using poisson regression model with robust standard errors fitted, where adjusted relative risk (ARR) with 95 % CI was used to interpret results.

Result: During the study period, a total of 196 patients were identified for assessment, of which 18 with incomplete records were excluded, resulting in 178 eligible patients for inclusion. The majority of participants were 40 or older (69.7 %) and female (51.1 %), presenting with symptoms lasting less than one week (68.5 %) and had at least one comorbid illness (70.8 %). The incidence of death was 16.5 deaths per 100 PD (95 % CI = 13.1 to 20.9). While triage to orange was associated with a decreased risk of death, high shock index, septic shock diagnosis, vasopressor use, and organ failure were associated with increased risk of death.

Conclusion: The incidence of mortality among shock patients was found to be considerable. To optimize patient care and improve outcomes, it is important to remain vigilant in the proper triage and early diagnosis of shock using more sensitive tools for prompt identification of high-risk cases, as well as to provide timely, prioritized and effective interventions.

Document Type

Article

PubMed ID

41323237