Thesis and Dissertations

Survival Status And Predictors of Mortality Among Stroke Patients at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, North West Ethiopia, 2020

Thu, 09 Jul 2020 00:00:00 GMT

Survival Status And Predictors of Mortality Among Stroke Patients at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, North West Ethiopia, 2020 Nigusie, Walelgn Introduction: Stroke is one of the commonest non communicable disease types that have a great public health impact both in developed and developing countries. However, in Ethiopia, the long term survival status of stroke patients was not well understood. Objective: This study was aimed to assess survival status and predictors of mortality among stroke patient at Felege hiwot comprehensive specialized hospital (FHCSH) from September 1, 2014 to August 31, 2019 Bahirdar, North West Ethiopia. Methods and materials: an institutional based retrospective cohort study was conducted among 368 registered stroke patients between September1, 2014 and August 31, 2019,and simple random sampling technique were used. Kaplan–Meier used to estimate survival rate with log rank test, to compare hazard of death covariate and both bi-variable and multivariable Cox regression analysis was conducted to identify predictors of mortality. Association was summarized using adjusted hazard ratio (AHR), and statistical significances were declared at 95% confidence interval (CI) and P-value < 0.05. Result: Of the368 stroke patients who were included in the analysis, 56 (15.2%) were died, and 312 (84.8%) were right censored. The overall survival rate was 72.2% at 51 months follow-up with median survival time of 0.26 months. Age greater than 65 (AHR= 6.31, 95% CI 1.75- 22.74), patients body temperature >37.1 degree centigrade (AHR = 7.14, 95% CI: 2.76-18.5), potassium level below <3.5 mmol/l (AHR =6.82, 95% CI: 1.9-23.53) and creatinine level >1.2 mg/dl (AHR = 7.85, 95% CI: 2.7-22.6), were the predictors of mortality. Conclusion and Recommendation age greater than 65 years, body temperature above 37.1degree centigrade, potassium level less than3.5 mmol/l, and Creatinine greater than1.2 mg/dl after admission. Therefore, interventions to reduce further mortality should focus in stroke patient. Key words: stroke, survival status, predictors, mortality, Ethiopia

Treatment Outcome and Associated Factors of Patients Underwent Gastrointestinal Surgery at Tibebe-Ghion Specialized Hospital: A Restrospective Cross-Sectional Study

Sat, 29 Oct 2022 00:00:00 GMT

Treatment Outcome and Associated Factors of Patients Underwent Gastrointestinal Surgery at Tibebe-Ghion Specialized Hospital: A Restrospective Cross-Sectional Study Worknesh, Baye Background: Surgery is an important public health intervention and occurs at a tremendous volume worldwide from the most resource rich to the most resource limited settings. This volume of surgery needs a great effort to improve the safety and availability of surgical services that will be sumed-up with good patient outcome. Even though adverse patient outcomes following gastrointestinal surgery is among the leading causes of morbidity and mortality, in Ethiopia limited studies have been conducted so far on the outcome of gastrointestinal surgery. Objective: To assess the outcome and associated factors of patients underwent gastro-intestinal surgery at Tibebe Ghion specialized Hospital, Bahir Dar, Ethiopia 2022. Methods: Institution-based retrospective cross-sectional study was conducted on records of patients treated at Tibebe Ghion specialized Hospital from January 8, 2020 to January 7, 2022. Secondary data were collected by using Pre-tested checklist from the patient charts. Data were entered into the Epi data version 4.6 and exported to SPSS version 25 for further analyses. A binary logistic regression model was used to identify the associated factors. Variables with P- value < 0.25 in the bivariable analysis was a candidate for multivariable analysis and P-value <0.05 in the multivariable analysis was used to declared as statistically significant. Results: From a total of 403 patients, 87 (21.6%) developed poor outcome of gastrointestinal surgery. Rural residency (AOR=3.21), morbidity status greater than or equal to ASAII (AOR=0.32), comorbid illness (AOR=3.67), post-operative length hospital of stay greater than or equal seven days (AOR=4.27), WHO surgical safety checklist utilization (AOR=3.14) and length of operating time (AOR=3.31) were significantly associated with poor outcome of GI surgery. Conclusion and recommendations: More than one-fifth of patients treated at Tibebe Ghion Specialized Hospital, experienced poor surgical outcome. Shortening hospital stays, effectively managing patients with comorbidities, and increasing awareness for rural populations can reduce the problem. Key words: Surgical outcome, gastrointestinal surgery, Tibebe Ghion Specialized Hospital, Ethiopia ABBREVIATIONS AND ACRONYMS

Short Term Outcomes and Causes of Perinatal Asphyxiaat Felegehiwot Comprehensive Specialized Hospital in Bahir Dar; Ethiopia.

Wed, 01 Jan 2020 00:00:00 GMT

Short Term Outcomes and Causes of Perinatal Asphyxiaat Felegehiwot Comprehensive Specialized Hospital in Bahir Dar; Ethiopia. Melkam Desta Background: Birth asphyxia is a failure to initiate and sustain breathing at birth. Birth asphyxia can lead to severe hypoxic organ damage to heart, lungs, liver, gut, kidneys, but brain damage is the concern, because mostly not totally reversed to its pre-event function. But there is a gap to know short term outcomes of perinatal asphyxia in FHCSH. Objectives: To assess short term outcomes and causes of perinatal asphyxia among neonates admitted to FHCSH. Methods: Institution based cross sectional study was used on 314 neonates admitted to FHCSH, from September, 2017 to February, 2019 G.C. The data was collected on October, one to ten, 2019. The whole population admitted to the hospital was included in the study. Chart review was done for each consecutive case by using the already adapted checklist.The data was coded and entered to the SPSS 20 version and basic descriptive stastical analysis was done. Result: there were a total of 314 perinatal asphyxia cases were admitted to the hospital in the study period. Death rate was high in this study 101(32.2%) from all studied subjects. Neonates with sarnat clinical stage Ⅲ perinatal asphyxia has poor prognosis with 27(31%) survival rate and 5(38.4%) of survivors discharged with sequelae, while Good short term outcome was seen in cases with sarnat clinical stage Ⅰ with 100% survival and discharged without sequel. Most perinatal asphyxia cases were labelled as stage Ⅱ 208(66.2%) in this study. Most mothers were gave birth via SVD 193(61.5%) and also males were mostly affected 192(61.1). Most of the study subjects were term 270(86%) and 218(69.4%) cases having NBW. Conclusion: the mortality rate of perinatal asphyxia was high. In this study mortality is associated with sarnat and sarnat clinical staging, complications of perinatal asphyxia, prematurity, home delivery and BW less than 2500grams.Therefore it is better to prevent perinatal asphyxia rather than treating after as well as preventing premature delivery and also prevent it’s complication. Key words: perinatal asphyxia, short term outcome, causative factors of perinatal asphyxia

Time to First Optimal Glycemic Control and its Predictors Among Type 1 Diabetic Children<15 Years In Bahir Dar City Public Referral Hospitals, North West, Ethiopia, 2021

Tue, 01 Jun 2021 00:00:00 GMT

Time to First Optimal Glycemic Control and its Predictors Among Type 1 Diabetic Children<15 Years In Bahir Dar City Public Referral Hospitals, North West, Ethiopia, 2021 Fentahun, Meseret Background: Recognizing the level of glycemic control of a client is an important predictor of the development of complication and risk of death from diabetes. However, the other most important predictor which is the time that the patient stayed in that poor glycemic level before reaching optimal glycemic control has not been studied so far. Objective: The aim of this study was to estimate time to first optimal glycemic control and identify predictors among type 1 diabetic children<15 years in Bahir Dar city public referral hospitals, Northwest, Ethiopia, 2021 Methods: Retrospective cohort study was conducted at Bahir Dar city public referral hospitals among randomly selected sample of 385 patients with type 1 diabetes who were on follow up from January1, 2016 to February30, 2021.Data were collected by using data abstraction tool and then entered into Epi-data version 3.1 and exported into STATA 14.2 statistical software. Descriptive statistics, Kaplan Meier plots and median survival times, Log-rank test and Cox-proportional hazard regression were used for analysis. After performing Cox-proportional hazard regression, model goodness-of-fit and assumptions were checked. Finally, association between independent variables and time to first optimal glycemic control in months were assessed using multivariable Cox Proportional Hazard model and Variables with p-value < 0.05 were considered as statistically significant. Result: Median survival time to first optimal glycemic control among type 1 diabetic client was 8 months (95%CI: 6.9-8.9).First optimal glycemic achievement rate was 8.2(95%CI: 7.2-9.2) per 100 person/month observation. Factors that affect time to first optimal glycemic control were age (AHR=0.32;95%CI=0.19-0.55),weight(AHR=0.96;95%CI=0.94-0.99),primary care giver(AHR=2.09;95%CI=1.39-3.13), insulin dose (AHR=1.05;95%CI=1.03-1.08),duration of diabetes (AHR=0.64;95%CI=0.44-0.94), adherence (AHR=9.72;95%CI=6.09-15.51),carbohydrate counting(AHR=2.43;95%CI=1.12-5.26),and comorbidity (AHR=0.72;95%CI=0.53-0.98). Conclusion and Recommendation: Median survival time to first optimal glycemic control among type 1 diabetic clients were too long.which, indicates that clients are being unprotected for complication. Hence, diabetic care should be strengthen to shorten time to first optimal glycemic control. Key words: type 1 diabetes mellitus, First optimal glycemic control, Time, children, Ethiopia