Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study
Background. Critical care in Uganda is a neglected speciality and deemed costly with limited funding/prioritization. We studied admission X-ray and MEWS as mortality predictors of ICU patients requiring mechanical ventilation. Materials and Methods. We did a cross-sectional study in Mulago Hospital...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/7134854 |
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| author | Hannington Ssemmanda Tonny Stone Luggya Clare Lubulwa Zeridah Muyinda Pascal Kwitonda Humphrey Wanzira Joseph Ejoku |
| author_facet | Hannington Ssemmanda Tonny Stone Luggya Clare Lubulwa Zeridah Muyinda Pascal Kwitonda Humphrey Wanzira Joseph Ejoku |
| author_sort | Hannington Ssemmanda |
| collection | DOAJ |
| description | Background. Critical care in Uganda is a neglected speciality and deemed costly with limited funding/prioritization. We studied admission X-ray and MEWS as mortality predictors of ICU patients requiring mechanical ventilation. Materials and Methods. We did a cross-sectional study in Mulago Hospital ICU and 87 patients for mechanical ventilation were recruited with mortality as the outcome of interest. Chest X-ray results were the main independent variable and MEWS was also gotten for all patients. Results. We recruited 87 patients; most were males (60.92%), aged between 16 and 45 years (59.77%), and most admissions for mechanical ventilation were from the Trauma Unit (30.77%). Forty-one (47.13%) of the 87 patients died and of these 34 (53.13%) had an abnormal CXR with an insignificant IRR = 1.75 (0.90–3.38) (p=0.062). Patients with MEWS ≥ 5 (p values = 0.018) and/or having an abnormal superior mediastinum (p values = 0.013) showed a positive association with mortality while having a MEWS ≥ 5 had an incidence risk ratio = 3.29 (1.00–12.02) (p=0.018). MEWS was a good predictor of mortality (predictive value = 0.6739). Conclusion. Trauma (31%) caused most ICU admissions, having an abnormal admission chest X-rays positively associated with mortality and a high MEWS was also a good predictor of mortality. |
| format | Article |
| id | doaj-art-c19465c4ebd5451c9efdbb57207f8190 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-c19465c4ebd5451c9efdbb57207f81902025-02-03T01:01:03ZengWileyCritical Care Research and Practice2090-13052090-13132016-01-01201610.1155/2016/71348547134854Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational StudyHannington Ssemmanda0Tonny Stone Luggya1Clare Lubulwa2Zeridah Muyinda3Pascal Kwitonda4Humphrey Wanzira5Joseph Ejoku6Directorate of Surgery Surgical Services, Mulago National Referral Hospital, Kampala, UgandaDepartment of Anaesthesia, Makerere University College of Health Sciences, Kampala, UgandaDirectorate of Surgery Surgical Services, Mulago National Referral Hospital, Kampala, UgandaDepartment of Radiology, Mulago National Referral Hospital, Kampala, UgandaDepartment of Radiology, Mulago National Referral Hospital, Kampala, UgandaDepartment of Epidemiology, Ministry of Health Uganda, Kampala, UgandaDirectorate of Surgery Surgical Services, Mulago National Referral Hospital, Kampala, UgandaBackground. Critical care in Uganda is a neglected speciality and deemed costly with limited funding/prioritization. We studied admission X-ray and MEWS as mortality predictors of ICU patients requiring mechanical ventilation. Materials and Methods. We did a cross-sectional study in Mulago Hospital ICU and 87 patients for mechanical ventilation were recruited with mortality as the outcome of interest. Chest X-ray results were the main independent variable and MEWS was also gotten for all patients. Results. We recruited 87 patients; most were males (60.92%), aged between 16 and 45 years (59.77%), and most admissions for mechanical ventilation were from the Trauma Unit (30.77%). Forty-one (47.13%) of the 87 patients died and of these 34 (53.13%) had an abnormal CXR with an insignificant IRR = 1.75 (0.90–3.38) (p=0.062). Patients with MEWS ≥ 5 (p values = 0.018) and/or having an abnormal superior mediastinum (p values = 0.013) showed a positive association with mortality while having a MEWS ≥ 5 had an incidence risk ratio = 3.29 (1.00–12.02) (p=0.018). MEWS was a good predictor of mortality (predictive value = 0.6739). Conclusion. Trauma (31%) caused most ICU admissions, having an abnormal admission chest X-rays positively associated with mortality and a high MEWS was also a good predictor of mortality.http://dx.doi.org/10.1155/2016/7134854 |
| spellingShingle | Hannington Ssemmanda Tonny Stone Luggya Clare Lubulwa Zeridah Muyinda Pascal Kwitonda Humphrey Wanzira Joseph Ejoku Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study Critical Care Research and Practice |
| title | Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study |
| title_full | Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study |
| title_fullStr | Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study |
| title_full_unstemmed | Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study |
| title_short | Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study |
| title_sort | abnormal admission chest x ray and mews as icu outcome predictors in a sub saharan tertiary hospital a prospective observational study |
| url | http://dx.doi.org/10.1155/2016/7134854 |
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