title: Intensive care medicine in rural sub-Saharan Africa.
abstract: We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).
authors.affiliation: Department of Anesthesiology, Peri-operative Medicine and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Private Medical University, Salzburg, Austria.|Global Intensive Care Working Group, European Society of Intensive Care Medicine, Brussels, Belgium.
authors.forename: M W
authors.initials: MW
authors.lastname: Dünser
authors.affiliation: Department of Anaesthetics and Intensive Care, St. Mary's Hospital Lacor, Gulu, Uganda.
authors.forename: R M
authors.initials: RM
authors.lastname: Towey
authors.affiliation: Department of Anaesthetics and Intensive Care, St. Mary's Hospital Lacor, Gulu, Uganda.
authors.forename: J
authors.initials: J
authors.lastname: Amito
authors.affiliation: Global Intensive Care Working Group, European Society of Intensive Care Medicine, Brussels, Belgium.|Intensive Care Unit, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Mer
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D055815:Young Adult
keywords: Africa; epidemiology; intensive care medicine; mechanical ventilation; mortality