Saltar al contenido principal

ETHNOS_APP

Inicio • Búsqueda • Revistas • Lista 0

Hospital burden of critical illness across global settings

A point prevalence and cohort study in Malawi, Sri Lanka and Sweden

Datos Bibliográficos

ID21880229
AutoresCarl Otto Schell (0000-0002-7904-1336, Uppsala University), Raphael Kazidule Kayambankadzanja Raphael Kazidule Kayambankadzanja (Program for Appropriate Technology in Health), Raphael Kazidule Kayambankadzanja (0000-0003-2242-8975), Abi Beane (0000-0003-4058-7670, MRC Centre for Regenerative Medicine), Andreas Wellhagen (0000-0002-0816-6932, Uppsala University), Chamira Kodippily (0000-0002-7186-3351, University of Colombo), Anna Hvarfner (0000-0002-1718-0007, Karolinska Institutet), Grace Banda (University of Malawi), Nalayini Jegathesan (0000-0003-3631-619X, Jaffna Teaching Hospital), Christoffer Hintze (0009-0007-6232-9169, Karolinska University Hospital), Wageesha Wijesiriwardana (National Hospital of Sri Lanka), Martin Gerdin Wärnberg (0000-0001-6069-4794, Karolinska University Hospital), Jayasingha Arachchilage Sujeewa (DGH Monaragala, Monaragala, Sri Lanka), Mtisunge Kachingwe (Queen Elizabeth Central Hospital), Petronella Bjurling‐Sjöberg (0000-0003-0245-3057, Uppsala University), Isaac Mbingwani (Public Health Institute of Malawi), Annie Kalibwe Mkandawire (0009-0001-7816-1504, University of Malawi), Hampus Sjöstedt (0000-0002-1021-8308, Uppsala University), Wezzie Kumwenda-Mwafulirwa (University of Malawi), Rajendra Surenthirakumaran (0000-0001-8252-8076, University of Jaffna), Surenthirakumaran Rajendra (Department of Community and Family Medicine, University of Jaffna Faculty of Medicine, Jaffna, Sri Lanka), Odala Kamandani Dzinjalamala (University of Malawi), Cecilia Stålsby Lundborg (0000-0001-6525-1861, Karolinska Institutet), Kwazizira Samson Mndolo (Ministry of Health, Lilongwe, Malawi), Miklós Lipcsey (0000-0002-1976-4129, Uppsala University), Rashan Haniffa (0000-0002-8288-449X, National Hospital of Sri Lanka), Lisa Kurland (0000-0003-3290-4111, Örebro University), Markus Castegren (0000-0002-9292-0298, Uppsala University), Tim Baker (0000-0002-6423-9948, Muhimbili University of Health and Allied Sciences)
Año2025
Volumen10
Número3
Páginase017119
Fecha de publicación2025-03-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-017119
PMID40132811
OpenAlexW4408834047
IdiomaEN
Citas recibidas1
Referencias citadas53

INTRODUCTION: The burden of critical illness may have been underestimated. Previous analyses have used data from intensive care units (ICUs) only, and there is a lack of evidence about where in hospitals critically ill patients receive care. This study aims to determine the burden of critical illness among adult inpatients across hospitals in different global settings. METHODS: We performed a prospective, observational, hospital-based, point prevalence and cohort study in countries of different socioeconomic levels: Malawi, Sri Lanka and Sweden. On specific days, all adult in-patients in the eight study hospitals were examined by the study team for the presence of critical illness and followed up for hospital mortality. Patients with at least one severely deranged vital sign were classified as critically ill. The primary outcomes were the presence of critical illness and 30-day hospital mortality. In addition, we determined where the critically ill patients were being cared for and the association between critical illness and 30-day hospital mortality. RESULTS: Among 3652 hospitalised patients, we found a point prevalence of critical illness of 12.0% (95% CI 11.0 to 13.1), with a hospital mortality of 18.7% (95% CI 15.3 to 22.6). The crude OR of death of critically ill patients compared with non-critically ill patients was 7.5 (95% CI 5.4 to 10.2). Of the critically ill patients, 96.1% (95% CI 93.9 to 97.6) were cared for in the general wards outside ICUs. CONCLUSIONS: The study has revealed a substantial burden of critical illness in hospitals from different global settings. One in eight hospital in-patients was critically ill, 19% of the critically ill died in hospital, and 96% of the critically ill patients were cared for outside of ICUs. Implementing the most feasible and low-cost critical care in general wards throughout hospitals would impact a large number of high-risk patients and has the potential to improve outcomes across all acute care specialties

Cohort study · Critical illness · Critically ill · Intensive care · Intensive care medicine · Observational study · Prospective cohort study · Severity of illness · Medicine · Nosocomial Infections in ICU · Sepsis Diagnosis and Treatment · Trauma and Emergency Care Studies · Emergency Medicine · Internal Medicine

  • Top ten research priorities for Essential Emergency and Critical Care

    Open Access•R Ellis, Ryan Rhys Ellis et al.•PLOS Global Public Health•2026

  • Global, regional, and national levels and causes of maternal mortality during 1990–2013

    Open Access•Nicholas J Kassebaum, Amelia Bertozzi-Villa et al.•The Lancet•2014

  • Mortality due to low-quality health systems in the universal health coverage era

    Open Access•Margaret E Kruk, Anna D Gage et al.•The Lancet•2018

  • Global, regional, and national sepsis incidence and mortality, 1990–2017

    Open Access•Kristina E Rudd, Sarah C Johnson et al.•The Lancet•2020

  • Establishment of a high-dependency unit in Malawi

    Open Access•Ben Morton, Ndaziona Peter Kwanjo Banda et al.•BMJ Global Health•2020

  • Cost-effectiveness and sustainability of improved hospital oxygen systems in Nigeria

    Open Access•Hamish R Graham, Ayobami A Bakare et al.•BMJ Global Health•2022

  • Modelling the cost-effectiveness of essential and advanced critical care for Covid-19 patients in Kenya

    Open Access•Angela Kairu, Vincent Were et al.•BMJ Global Health•2021

  • Essential Emergency and Critical Care

    Open Access•Carl Otto Schell, Karima Khalid et al.•BMJ Global Health•2021

  • Critical care delivery across health care systems in low-income and low-middle-income country settings

    Open Access•Emily S Bartlett, Andrew Lim et al.•Journal of Global Health•2023

Obras citantes distintas1
Citas por año1
Intervalo de citas2026 - 2026 (1)
Velocidad de citacióncurrent
Altamente citadoNo
Tipos de citaNeutras: 1
Ethnos_APP • Proyecto Open Source • Licencia MIT • Frontend v2.0.0 • Privacidad y Cookies • Documentación de la API: api.ethnos.app/docs • Código de la API: GitHub • DOI: 10.5281/zenodo.17049435 • Código del Frontend: GitHub • DOI: 10.5281/zenodo.17050053 • cruz.rio.br • Expectantes Misericordiae