Determinants of Early Mortality Among Deaths at Adult Emergency Departments in Southern Ethiopia

Abstract

BackgroundIn Ethiopia, the first 3 days (72 h) after admission to the emergency department (ED) account for more than half (59.8%) of all deaths. However, little is known about the prevalence of early mortality and its associated factors in southern Ethiopia. ObjectiveThe main objective of this study is to assess the prevalence and associated factors of early mortality among deaths in adult EDs at selected public hospitals in Hawassa, southern Ethiopia. MethodsAn institutional-based retrospective cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in the adult EDs of selected public hospitals in the past 2 years. The data were collected using a standardized and pretested data abstraction tool using the Kobo Toolbox data collection tool. Logistic regression analyses were carried out to assess the strength of the association. Statistical significance was declared at p-value < 0.05, and an adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association. ResultAccording to the results of the current study, 288 patients, or 78% of the total, passed away within 72 h of admission to the ED. The following variables were significantly associated with early mortality: delayed initial intervention (AOR 2.338), red triage categories (AOR 3.9), lack of investigation (AOR 3.4), comorbid illness (AOR 3.2), absence of prehospital treatment (AOR 4.2), and road traffic accidents (AOR 4.1). ConclusionThere was an increased early mortality rate seen in this investigation. The following factors were significantly associated with an early death in the ED: comorbidity, delayed intervention, red warning score, road traffic accidents, absence of prehospital treatment, and lack of diagnostic testing. By addressing the variables that are strongly linked to an early mortality, every intervention should be undertaken to reduce the risk of an early death.