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Meta-Analysis
. 2024 Jul 23;19(7):e0306277.
doi: 10.1371/journal.pone.0306277. eCollection 2024.

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Temesgen Ayenew  1 , Mihretie Gedfew  1 , Mamaru Getie Fetene  2 , Belayneh Shetie Workneh  3 , Animut Takele Telayneh  4 , Afework Edmealem  1 , Bekele Getenet Tiruneh  5 , Guadie Tewabe Yinges  6 , Addisu Getie  1 , Mengistu Abebe Meselu  1
Affiliations
Meta-Analysis

Prevalence of mortality among mechanically ventilated patients in the intensive care units of Ethiopian hospitals and the associated factors: A systematic review and meta-analysis

Temesgen Ayenew et al. PLoS One. .

Abstract

Background: In the intensive care unit (ICU), mechanical ventilation (MV) is a typical way of respiratory support. The severity of the illness raises the likelihood of death in patients who require MV. Several studies have been done in Ethiopia; however, the mortality rate differs among them. The objective of this systematic review and meta-analysis is to provide a pooled prevalence of mortality and associated factors among ICU-admitted patients receiving MV in Ethiopian hospitals.

Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria to conduct a comprehensive systematic review and meta-analysis in this study. We searched PubMed/Medline, SCOPUS, Embase, Hinari, and Web of Science and found 22 articles that met our inclusion criteria. We used a random-effects model. To identify heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger's regression test and funnel plots for assessing publication bias. STATA version 17.0 software was used for all statistical analyses.

Results: In this systematic review and meta-analysis, the pooled prevalence of mortality among 7507 ICU-admitted patients from 22 articles, who received MV was estimated to be 54.74% [95% CI = 47.93, 61.55]. In the subgroup analysis by region, the Southern Nations, Nationalities, and Peoples (SNNP) subgroup (64.28%, 95% CI = 51.19, 77.37) had the highest prevalence. Patients with COVID-19 have the highest mortality rate (75.80%, 95% CI = 51.10, 100.00). Sepsis (OR = 6.85, 95%CI = 3.24, 14.46), Glasgow Coma Scale (GCS) score<8 (OR = 6.58, 95%CI = 1.96, 22.11), admission with medical cases (OR = 4.12, 95%CI = 2.00, 8.48), Multi Organ Dysfunction Syndrome (MODS) (OR = 2.70, 95%CI = 4.11, 12.62), and vasopressor treatment (OR = 19.06, 95%CI = 9.34, 38.88) were all statistically associated with mortality.

Conclusion: Our review found that the pooled prevalence of mortality among mechanically ventilated ICU-admitted patients in Ethiopia was considerably high compared to similar studies in the United States (US), China, and other countries. Sepsis, GCS<8, medical cases, MODS, and use of vasopressors were statistically associated with mortality. Clinicians should exercise caution while mechanically ventilating ICU-admitted patients with these factors. However, it should be noted that the exact cause and effect relationship could not be established with this meta-analysis, as the available evidence is not sufficient. Thus, more studies using prospective methods will be required.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow-chart depicting the selection process of studies in Ethiopia, 2023.
Fig 2
Fig 2. Prevalence of mortality among intensive care unit patients who received mechanical ventilation in Ethiopia, 2023.
Fig 3
Fig 3. Subgroup analysis by region of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 4
Fig 4. Subgroup analysis by sample size of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 5
Fig 5. Subgroup analysis by type of ICU of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 6
Fig 6. Subgroup analysis by study design of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 7
Fig 7. Subgroup analysis by COVID-19 of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 8
Fig 8. Sensitivity analysis of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
Fig 9
Fig 9. Funnel plot of mortality among mechanically ventilated ICU patients in Ethiopia, 2023.
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