Characteristics and In-Hospital Outcomes of Patients With Septic Shock in the Adult Medical Intensive Care Unit of a Tertiary Hospital in Ethiopia: A Prospective Observational Study

Abstract

Background and Aims: Sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year and claiming the lives of one-sixth to one-third of those affected. However, there is insufficient data on the characteristics and outcomes of septic shock patients in resource-limited settings. This study aimed to assess the characteristics and in-hospital outcomes of septic shock among patients admitted to the adult medical intensive care unit (ICU) of a tertiary hospital in Ethiopia. Methods: A prospective observational study was conducted among patients diagnosed with septic shock according to consensus criteria who were admitted to the adult medical ICU of a tertiary hospital in Ethiopia from January 1, 2023, to September 30, 2023. Results: A total of 144 patients were included in this study, with a mean age of 46 ± 19 years. The respiratory system was the most common source of infection, affecting 70.2% of the patients. The blood culture positivity rate was 8.4%, and antibiotics were revised for only 2.8% of the patients tailored to culture results. Adrenaline was the most frequently used vasopressor (73.6%), followed by noradrenaline (27.8%). The main complications were acute kidney injury (51.4%) and acute lung injury (50.7%). The in-hospital mortality rate was 66.7%, with a median hospital stay of 6 days (interquartile range: 2–11 days). Multivariable Cox regression analysis showed that a Glasgow Coma Scale score below 15 (AHR: 2.23; 95% CI, 1.35–3.69) and peripheral oxygen saturation under 90% (AHR: 8.74; 95% CI, 1.18–14.84) were independently associated with increased in-hospital mortality risk. Conclusions: This study demonstrated a high mortality rate among septic shock patients with more than two-thirds of patients dying during their hospital stay. The significant prognostic indicators of in-hospital mortality were impaired mental status and peripheral oxygen desaturation.