ArticlePloS one2025
Diagnoses and critical care outcomes in a rural Tanzanian high dependency unit: A prospective cohort study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Applications of the Early Warning Score as an outcome measure: a systematic review of methodologies.BMJ health & care informatics · 2026Pooled it
- Intermediate Care Unit performance being properly assessed?Critical care (London, England) · 2025Article
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23 authors.
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Abstract
backgroundData on rural sub-Saharan African high-dependency units (HDU) are lacking. We describe patient's characteristics, diagnoses, and outcomes of patients admitted to a Tanzanian HDU, and identified factors associated with in-hospital mortality.
methodsThis prospective single-center cohort study was conducted in the HDU of a Tanzanian rural referral hospital. All patients admitted to the HDU were eligible. Descriptive analyses, and univariate and multivariate modeling to identify predictors of in-hospital mortality were done. Kaplan-Meier survival curves were employed to estimate mortality rates over time. The area under the receiver operating characteristic curve was used to assess the predictive accuracy of early warning scores.
resultsFrom April 4th 2023 to March 29th 2024, 491 patients were included and followed-up until hospital discharge. Median age was 46 years (IQR 29-65); 259 (53%) were females. Most common diagnoses were sepsis (N = 96, 20%), arterial hypertension (N = 91, 19%), diabetes mellitus (N = 84, 17%), acute kidney injury (N = 66, 13%), decompensated heart failure (N = 64, 13%), aspiration pneumonia (N = 60, 12%), and stroke (N = 59, 12%). Mortality during HDU- and hospital stay was 30%(N = 146) and 37%(N = 182), respectively. 54% of patients with sepsis, 51% with stroke, 65% with aspiration pneumonia and 27% with heart failure died in the HDU. Predictors of in-hospital mortality were age ≥ 45 years versus 18-44 (adjusted Hazard Ratio (aHR) 1.56, 95% CI 1.07-2.28, p = 0.03), blood pressure <90mmHg (aHR 2.33, 95%CI 1.48-3.81, p < 0.001), Glasgow Coma Scale score ≤8 versus 14-15 (aHR 2.13, 95%CI 1.24-3.64, p = 0.02) and oxygen saturation at room air < 90% (aHR 1.62, 95%CI 1.04-2.51, p = 0.03). The area under the curve predicting in-hospital mortality was 0.69 (95%CI 0.65-0.73) for the NEWS- and UVA scores, 0.66 (95%CI 0.62-0.70) for the MEWS-, and 0.65 (95%CI 0.61-0.69) for the qSOFA score.
conclusionSepsis and non-communicable diseases were the most common diagnoses. Scores predicted in-hospital mortality with a moderate accuracy.
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