World Journal of Surgery

, Volume 40, Issue 12, pp 2847–2856 | Cite as

Retrospective Descriptive Study of an Intensive Care Unit at a Ugandan Regional Referral Hospital

  • Stephen S. Ttendo
  • Adam Was
  • Mark A. Preston
  • Emmanuel Munyarugero
  • Vanessa B. Kerry
  • Paul G. Firth
Original Scientific Report



We describe delivery and outcomes of critical care at Mbarara Regional Referral Hospital, a Ugandan secondary referral hospital serving a large, widely dispersed rural population.


Retrospective observational study of ICU admissions was performed from January 2008 to December 2011.


Of 431 admissions, 239 (55.4 %) were female, and 142 (33.2 %) were children (<18 years). The median length of stay was 2 (IQR 1–4) days, with 365 patients (85 %) staying less than 8 days. Indications for admission were surgical 49.3 % (n = 213), medical/pediatric 27.4 % (n = 118), or obstetrical/gynecological 22.3 % (n = 96). The overall mortality rate was 37.6 % (162/431) [adults 39.3 % (n = 113/287), children 33.5 % (n = 48/143), unspecified age 100 % (n = 1/1)]. Of the 162 deaths, 76 (46.9 %) occurred on the first, 20 (12.3 %) on the second, 23 (14.2 %) on the third, and 43 (26.5 %) on a subsequent day of admission. Mortality rates for common diagnoses were surgical abdomen 31.9 % (n = 29/91), trauma 45.5 % (n = 30/66), head trauma 59.6 % (n = 28/47), and poisoning 28.6 % (n = 10/35). The rate of mechanical ventilation was 49.7 % (n = 214/431). The mortality rate of ventilated patients was 73.5 % (n = 119/224). The multivariate odd ratio estimates of mortality were significant for ventilation [aOR 6.15 (95 % CI 3.83–9.87), p < 0.0001] and for length of stay beyond seven days [aOR 0.37 (95 % CI 0.19–0.70), p = 0.0021], but not significant for decade of age [aOR 1.06 (95 % CI 0.94–1.20), p = 0.33], gender [aOR 0.61(95 % CI 0.38–0.99), p = 0.07], or diagnosis type [medical vs. surgical aOR 1.08 (95 % CI 0. 63–1.84), medical vs. obstetric/gynecology aOR 0.73 (95 % CI 0.37–1.43), p = 0.49].


The ICU predominantly functions as an acute care unit for critically ill young patients, with most deaths occurring within the first 48 h of admission. Expansion of critical care capacity in low-income countries should be accompanied by measurement of the nature and impact of this intervention.


Intensive Care Unit Critical Care Admission Diagnosis Ventilation Status Acute Care Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We wish to thank Manfred Amanya (data entry) and Nicholas Musinguzi M.Sc. and K. Trudy Poon M.Sc. (statistical analysis).


Funding was provided by MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.


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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Stephen S. Ttendo
    • 1
  • Adam Was
    • 2
  • Mark A. Preston
    • 3
  • Emmanuel Munyarugero
    • 1
  • Vanessa B. Kerry
    • 4
  • Paul G. Firth
    • 5
  1. 1.Department of Anaesthesia and Critical CareMbarara Regional Referral HospitalMbararaUganda
  2. 2.Department of PediatricsLucile Packard Children’s Hospital at StanfordPalo AltoUSA
  3. 3.Department of SurgeryBrigham and Woman’s HospitalBostonUSA
  4. 4.Department of MedicineMassachusetts General HospitalBostonUSA
  5. 5.Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General HospitalBostonUSA

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