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Critical Care Research and Practice
Volume 2016, Article ID 7134854, 7 pages
http://dx.doi.org/10.1155/2016/7134854
Research Article

Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study

1Directorate of Surgery Surgical Services, Mulago National Referral Hospital, Kampala, Uganda
2Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
3Department of Radiology, Mulago National Referral Hospital, Kampala, Uganda
4Department of Epidemiology, Ministry of Health Uganda, Kampala, Uganda

Received 1 March 2016; Revised 19 June 2016; Accepted 3 July 2016

Academic Editor: Samuel A. Tisherman

Copyright © 2016 Hannington Ssemmanda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Critical care in Uganda is a neglected speciality and deemed costly with limited funding/prioritization. We studied admission X-ray and MEWS as mortality predictors of ICU patients requiring mechanical ventilation. Materials and Methods. We did a cross-sectional study in Mulago Hospital ICU and 87 patients for mechanical ventilation were recruited with mortality as the outcome of interest. Chest X-ray results were the main independent variable and MEWS was also gotten for all patients. Results. We recruited 87 patients; most were males (60.92%), aged between 16 and 45 years (59.77%), and most admissions for mechanical ventilation were from the Trauma Unit (30.77%). Forty-one (47.13%) of the 87 patients died and of these 34 (53.13%) had an abnormal CXR with an insignificant IRR = 1.75 (0.90–3.38) (). Patients with MEWS ≥ 5 ( values = 0.018) and/or having an abnormal superior mediastinum ( values = 0.013) showed a positive association with mortality while having a MEWS 5 had an incidence risk ratio = 3.29 (1.00–12.02) (). MEWS was a good predictor of mortality (predictive value = 0.6739). Conclusion. Trauma (31%) caused most ICU admissions, having an abnormal admission chest X-rays positively associated with mortality and a high MEWS was also a good predictor of mortality.