Unplanned extubation is the removal of an endotracheal tube accidently during procedural activities or by the action of the patient. It is one of the commonly reported complications among mechanically ventilated patients in the intensive care unit. This study aimed to assess the magnitude and associated factors of unplanned extubation in intensive care units at referral hospitals in Addis Ababa, Ethiopia, 2021. Institutional based prospective observational study was conducted on 317 intubated patients in the intensive care unit at referral hospitals of Addis Ababa, Ethiopia, from January 8, 2021–May 9, 2021. Data were collected using a structured questionnaire. Descriptive statics were expressed in percentages and presented with tables and figures. Both Bivariable and multivariable logistic analysis was done to identify factors associated with unplanned extubation in intensive care unit. P < 0.05 with 95% CI was set as Statistical significance. The prevalence of unplanned extubation in this study was 19.74%. Being male (AOR = 3.132, 95%CI: 1.276–7.69), duration of intubation <5days (AOR = 2.475, 95% CI: 1.039–5.894), managed by junior resident (AOR = 5.25, 95% CI: 2.125–12.969), being physically restrained (AOR = 4.356, 95%CI: 1.786–10.624), night shift (AOR = 3.282, 95%CI:1.451–7.424)and agitation (AOR = 4.934,95%CI:1.934–12.586) were significantly contribute to the occurrence of unplanned extubation. and recommendation: This study showed that the prevalence of unplanned extubation was high in the intensive care unit. We suggest to intensive care unit staff to give special attention to early intubated patients, especially male individuals and the stakeholders of hospitals should rearrange the time of shift and physician schedules in the intensive care unit.

There is concern that patients admitted to the intensive care unit (ICU) with Corona Virus Disease 2019 (COVID-19) have variable prevalence reports of mortality. The survival rates are also inconsistently reported due to varying follow-up periods. Even if data on outcomes and baseline characteristics of ICU patients with COVID-19 is essential for action planning to manage complications, it is still left undisclosed in our study setting. This cross-sectional study was conducted on 402 samples using a retrospective chart review of patient's data who were admitted in the past 2 years of the adult ICUs. All the data were entered and analyzed with SPSS version 21. A multivariable Logistic regression analysis was used to identify the association between outcome variables with independent factors and a p-value of less than 0.05 was taken as statistically significant with a 95% confidence interval. We used text, tables, and figures for the result. The overall prevalence of mortality among adult patients admitted to ICU during COVID-19 pandemics was 67.4%. From the multivariable logistic regression analysis, factors that were shown to have an association with an increase in ICU patient mortality were; lack of Vasopressor support, patients who had confirmed COVID 19 infection, core body temperature at admission greater than 37.5 °c, SPO2 at admission less than 90%, patients who had diagnosed ischemic heart disease (IHD), patients with acute respiratory distress syndrome (ARDS), patients who were intubated and mechanically ventilated (MV), and patient's ICU length of stay longer than two weeks. The prevalence of ICU mortality in adult patients was higher in Debre Tabor Comprehensive specialized hospital. Therefore, clinicians need to minimize factors that maximize patient mortalities like ARDS, hyperthermia, Desaturation, Covid infection, IHD, intubation and MV, lack of Vasopressor use, and prolonged ICU stay.

Hypothermia is a core body temperature of less than 36 c⁰ that could increase perioperative morbidity & mortality of pediatric patients operated under general anesthesia. This study aimed to assess the magnitude and associated factors of intra-operative hypothermia among pediatric patients undergoing elective surgery. Institutional based cross-sectional study was conducted on 339 pediatric patients undergoing elective surgery in referral hospitals of Addis Ababa, Ethiopia. Data were collected using a structured questionnaire. Descriptive statics were expressed in percentage and presented with tables. Both Bivariable and multivariable logistic analysis was done to identify factors associated with intra-operative hypothermia among pediatric patients undergoing elective surgery. P < 0.05 with 95% CI was set as statistical significance. The magnitude of intra-operative hypothermia in this study was 39.8 [95% CI= (34.5–45.1)]. Multivariable logistic analyses showed that ambient temperature less than 26c⁰ [AOR = 6; 95%CI=(2.859–13.23)], volume of fluid administered greater than half a liter [AOR = 3.6; 95%CI=(1.83–7.23)], Patients who were received un-warm fluid [AOR = 2.2; 95%CI=(1.28–4.04)] and duration of surgery and anesthesia greater than 120 min [AOR = 3.4; 95%CI=(1.29–8.79)] and [AOR = 3.8; 95%CI=(1.25–11.53)] respectively were factors significantly associated with intra-operative hypothermia. The magnitude of intra-operative hypothermia in this study was high. So, adherence must be done in the prevention of intraoperative hypothermia by health professionals such as increasing operation room temperature, warming administered fluid, optimal fluid administration, and reduction of the duration of surgery and anesthesia.

Background: Preoperative anemia is a common hematologic problem in major orthopedic surgery in developing countries. It is a condition in which the number and size of red blood cells are insufficient to meet the body’s physiologic needs, consequently impairing the capacity of the blood to transport oxygen to the body. Preoperative anemia is common in elective orthopedic surgical patients and is an independent risk factor for perioperative morbidity and mortality. This study aimed to assess preoperative anemia prevalence and risk factors in patients undergoing elective orthopedic procedures. Method: A multicenter prospective observational cohort study was conducted from June 01 to August 30, 2022. A systematic random sampling technique was used to select the study unit. Data were collected using a structured questionnaire. Descriptive statistics were expressed in percentages and presented with tables and figures. Binary logistic regression was used to see the association between independent and dependent variables. A P-value < 0.05 was considered statistically significant. Result: Preoperative anemia’s prevalence and risk factors in patients undergoing elective orthopedic procedures was 24.1[95%CI= (18.2–30.6)]. Multivariable logistic analyses showed that low monthly income level [AOR:5,95%CI:(1.36–7.98)], patient with cancer [AOR:3.4,95%CI:(3.7–8.84)], patient with malaria infectious [AOR: 3.2,95%CI:( 1.13–8.91)], patient with anti-retroviral therapy [AOR: 5.2,95%CI:( 1.8-11.04)], and previous history of surgery [AOR:1,95%CI(1.43–2.4)], were factors significantly associated with preoperative anemia. Conclusion: The prevalence of preoperative anemia among adult patients who underwent elective orthopedics procedures was high. Low Monthly income, patients with cancer, patient with malaria infection, and patients with anti-retroviral therapy, previous histories of surgery were found significantly associated with preoperative anemia. So, we recommend to health professional’s early identification, diagnosis and treatment of preoperative anemia should be done to reduce the risks of anemia and related adverse outcomes.

Ventriculoperitoneal (VP) shunting is one of the most common neurosurgical procedures for treating hydrocephalus. This study aimed to assess the Survival status and determinant factors of pediatric patients who underwent ventriculoperitoneal shunting for hydrocephalus. A multicenter institutional-based retrospective cohort study was employed by reviewing medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus from 1/12/2015 to 30/02/2023 and the medical chart records review was employed from 1/03/2023 to 30/03/2023. Data were extracted using a pre-tested, structured questionnaire. The Cox proportional hazard model was used to identify determinants of pediatric patient survival, where the hazard ratio, p-values, and 95% CI for adjusted hazard ratio were used to test significance and interpret the results. A p-value of < 0.05 was considered statistically significant. Seven hundred sixty-nine medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus were selected and reviewed with a response rate of 87.89%. The median survival time of pediatric patients after surgery was 15 months. On the multivariable Cox proportional hazard model, ultrasound image (AHR: 4.257, 95% CI: 2.07–8.74), emergency type of surgery (AHR: 2.180, 95% CI: 1.20–3.95), additional procedures other than shunting (AHR: 2.089, 95% CI: 1.05–4.16), duration of stay (> 7 days) (AHR: 4.014, 95% CI: 1.28–12.57), shunt failure (AHR: 4.163, 95% CI: 2.32–7.47), and clinical follow-up (AHR: 2.606, 95% CI: 1.31–5.17) were found to be determinants factors of survival status the patients. The survival time to death was 15 months, and the mortality rate for shunting surgery for hydrocephalus was 24.58%. In this study, emergency type of surgery, additional procedures other than shunt, duration of stay (> 7 days), shunt failure, and no hospital follow-up were factors associated with the mortality of the patients.

Objective To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025. Design A multicentre prospective observational study was conducted. Setting Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025. Participants A total of 351 patients were included in the final analysis during the study period. Outcome measures The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units. Results The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) ≥1) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium. Conclusion and recommendation In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS≥1) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.