C55-06 Prospective Observational Study on Incidence and Outcomes of Hypoxemia Among Adult Patients Presenting to the Medical Emergency Department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Rationale Hypoxemia, defined as blood oxygen saturation (SpO2) <90%, is a life-threatening condition commonly associated with respiratory and critical illnesses. It contributes significantly to morbidity and mortality, particularly in resource-limited settings. Data on the incidence, causes, and outcomes of hypoxemia among adult patients in Ethiopia remain scarce. This study aimed to determine the incidence of hypoxemia in adults presenting to the emergency department, identify common predisposing conditions, and assess in-hospital outcomes and determinants of mortality. Methods A prospective observational study was conducted at the Adult Emergency Department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, from June to September 2025. Consecutive adults (≥18 years) with hypoxemia (SpO2 <90%) and emergency department(ED) stay ≥24 hours were enrolled. Data on demographics, comorbidities, etiology, hypoxemia severity, and outcomes were collected using a structured questionnaire. Descriptive statistics and logistic regression were performed using SPSS v26, with p < 0.05 considered significant. Ethical approval and informed consent were obtained. Results Between June and September 2025, the Emergency Department admitted 4,716 patients, of whom 282 had hypoxemia. The incidence rate of hypoxemia was 6% of admissions, or 60 per 1,000 patients. A total of 282 patients were included (median age 45 years, IQR 32.8-60; 49.3% male). Most (89.4%) had at least one comorbidity, notably cancer (34.8%), congestive heart failure (22.3%), hypertension (19.2%), and chronic lung disease (15.3%). Leading causes of hypoxemia were sepsis (46.1%), respiratory causes (44.7%), and cardiogenic causes (21.3%). Overall survival was 61.7%, with 33.3% mortality and 5% leaving against medical advice. Multivariable analysis identified independent predictors of mortality: presence of any comorbidity (AOR = 7.11, p = 0.029), cancer (AOR = 7.48, p = 0.001), higher sequential organ failure assessment (SOFA) scores (AOR = 1.63, p < 0.001), and in-hospital complications (AOR = 29.32, p < 0.001). Interestingly, diabetes mellitus was associated with improved survival (AOR = 0.19, p = 0.030). Conclusion Hypoxemia affected 6% of adult emergency department admissions and is associated with high mortality. Comorbidities, especially cancer, higher organ dysfunction (SOFA scores), and hospital-acquired complications significantly increase the risk of death. Early recognition, aggressive management of complications, and strengthening critical care resources are essential to improve outcomes in resource-limited settings.