Acute Hypoxaemic Respiratory Failure In A Low-Income Country: A Prospective Observational Study Of Hospital Prevalence And Mortality

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dc.contributor.authorKwizera, Arthur
dc.contributor.authorNakibuuka, Jane
dc.contributor.authorNakiyingi, Lydia
dc.contributor.authorSendagire, Cornelius
dc.contributor.authorTumukunde, Janat
dc.contributor.authorKatabira, Catherine
dc.contributor.authorSsenyonga, Ronald
dc.contributor.authorKiwanuka, Noah
dc.contributor.authorKateete, David Patrick
dc.contributor.authorJoloba, Moses
dc.contributor.authorKabatoro, Daphne
dc.contributor.authorAtwine, Diana
dc.contributor.authorSummers, Charlotte
dc.date.accessioned2022-02-17T19:55:23Z
dc.date.available2022-02-17T19:55:23Z
dc.date.issued2020
dc.description.abstractLimited data exist on the epidemiology of acute hypoxaemic respiratory failure (AHRF) in low-income countries (LICs). We sought to determine the prevalence of AHRF in critically ill adult patients admitted to a Ugandan tertiary referral hospital; determine clinical and treatment characteristics as well as assess factors associated with mortality.We conducted a prospective observational study at the Mulago National Referral and Teaching Hospital in Uganda. Critically ill adults who were hospitalised at the emergency department and met the criteria for AHRF (acute shortness of breath for less than a week) were enrolled and followed up for 90 days. Multivariable analyses were conducted to determine the risk factors for death.A total of 7300 patients was screened. Of these, 327 (4.5%) presented with AHRF. The majority (60 %) was male and the median age was 38 years (IQR 27–52). The mean plethysmographic oxygen saturation (SpO2) was 77.6% (SD 12.7); mean SpO2/FiO2 ratio 194 (SD 32) and the mean Lung Injury Prediction Score (LIPS) 6.7 (SD 0.8). Pneumonia (80%) was the most common diagnosis. Only 6% of the patients received mechanical ventilatory support. In-hospital mortality was 77% with an average length of hospital stay of 9.2 days (SD 7). At 90 days after enrolment, the mortality increased to 85%. Factors associated with mortality were severity of hypoxaemia (risk ratio (RR) 1.29 (95% CI 1.15 to 1.54), p=0.01); a high LIPS (RR 1.79 (95% CI 1.79 1.14 to 2.83), p=0.01); thrombocytopenia (RR 1.23 (95% CI 1.11 to 1.38), p=0.01); anaemia (RR 1.15 (95% CI 1.01 to 1.31), p=0.03) ; HIV co-infection (RR 0.84 (95% CI 0.72 to 0.97), p=0.019) and male gender (RR 1.15 (95% CI 1.01 to 1.31) p=0.04).The prevalence of AHRF among emergency department patients in a tertiary hospital in an LIC was low but was associated with very high mortality. Pneumonia was the most common cause of AHRF. Mortality was associated with higher severity of hypoxaemia, high LIPS, anaemia, HIV co-infection, thrombocytopenia and being male.en_US
dc.identifier.citationKwizera, A., Nakibuuka, J., Nakiyingi, L., Sendagire, C., Tumukunde, J., Katabira, C., ... & Summers, C. (2020). Acute hypoxaemic respiratory failure in a low-income country: a prospective observational study of hospital prevalence and mortality. BMJ Open Respiratory Research, 7(1), e000719.http://dx.doi.org/10.1136/bmjresp-2020-000719en_US
dc.identifier.issn2052-4439
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2179
dc.language.isoenen_US
dc.publisherBMJ Open Respiratory Researchen_US
dc.titleAcute Hypoxaemic Respiratory Failure In A Low-Income Country: A Prospective Observational Study Of Hospital Prevalence And Mortalityen_US
dc.typeArticleen_US
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