Risk factors for mortality among eclamptics admitted to the surgical intensive care unit at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

AbstractBackground: Facilities for intensive care are scarce in low-resource settings. Identifyingdeterminants of mortality among eclamptics requiring intensive care will provide insightregarding prioritization as to which group of eclamptics would benefit from earlierreferral or transfer to ICU this will improve survival in the face of scarce resourcesavailable for ICU.Setting: Tikur Anbessa Hospital, a teaching and central referral hospital in Addis Ababa,Ethiopia.Objectives: To identify risk factors associated with mortality of eclamptics who requiredintensive care after admission to TAH- SICU.Methods: A ten years retrospective, hospital based case-control study. The case recordsof eclamptics admitted to the SICU during the study period were reviewed. Cases werethose mothers who died, with the survivors acting as controls. Several variables wereassessed among the cases and controls to assess their risk towards mortality; OR and95% CI computed.Results: The majority were below the age of 30 years, 124 (84.4%); nulliparous 103(70.1%) and from Addis 113 (76.9%). Lateralizing signs were observed in 11(7.5%). Agegreater than 29 years (OR 3.29; 95% CI, 1.18-9.12); being a housemaid (OR 5.93; 95%CI, 1.13-34.15); multiparity (OR 3.32, 95% CI 1.40-7.87) and the presence oflateralizing signs at admission (OR 4.57; 95% CI, 1.12-19.04) were significantlyassociated with the risk of mortality. The overall SICU case fatality rate was 25.9 %.Conclusion: More vigilant attention should be given to eclamptics older than 29 years,those with low-socioeconomic status, multiparous mothers and presence of lateralizingsigns at admission. Prioritizing ICU admission to these groups may improve survival.There is a need to conduct more studies on ICU mortality to come up with more detailedindications for prioritizing ICU admission.(Ethiop. J.Repr. Health .May 2007, 1(1):4-16)1. Ghandi Memorial Hospital, Addis Ababa, Ethiopia. 2.