{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T18:53:51Z","timestamp":1776106431966,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T00:00:00Z","timestamp":1470700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T00:00:00Z","timestamp":1470700800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"MGH Global Health, Massachusetts General Hospital","award":["Unrestricted"],"award-info":[{"award-number":["Unrestricted"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective observational study of ICU admissions was performed from January 2008 to December 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 431 admissions, 239 (55.4 %) were female, and 142 (33.2 %) were children (&lt;18 years). The median length of stay was 2 (IQR 1\u20134) days, with 365 patients (85 %) staying less than 8\u00a0days. Indications for admission were surgical 49.3 % (<jats:italic>n<\/jats:italic> = 213), medical\/pediatric 27.4 % (<jats:italic>n<\/jats:italic> = 118), or obstetrical\/gynecological 22.3 % (<jats:italic>n<\/jats:italic> = 96). The overall mortality rate was 37.6 % (162\/431) [adults 39.3 % (<jats:italic>n<\/jats:italic> = 113\/287), children 33.5 % (<jats:italic>n<\/jats:italic> = 48\/143), unspecified age 100 % (<jats:italic>n<\/jats:italic> = 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 % (<jats:italic>n<\/jats:italic> = 29\/91), trauma 45.5 % (<jats:italic>n<\/jats:italic> = 30\/66), head trauma 59.6 % (<jats:italic>n<\/jats:italic> = 28\/47), and poisoning 28.6 % (<jats:italic>n<\/jats:italic> = 10\/35). The rate of mechanical ventilation was 49.7 % (<jats:italic>n<\/jats:italic> = 214\/431). The mortality rate of ventilated patients was 73.5 % (<jats:italic>n<\/jats:italic> = 119\/224). The multivariate odd ratio estimates of mortality were significant for ventilation [aOR 6.15 (95 % CI 3.83\u20139.87), <jats:italic>p<\/jats:italic> &lt; 0.0001] and for length of stay beyond seven days [aOR 0.37 (95 % CI 0.19\u20130.70), <jats:italic>p<\/jats:italic> = 0.0021], but not significant for decade of age [aOR 1.06 (95 % CI 0.94\u20131.20), <jats:italic>p<\/jats:italic> = 0.33], gender [aOR 0.61(95 % CI 0.38\u20130.99), <jats:italic>p<\/jats:italic> = 0.07], or diagnosis type [medical vs. surgical aOR 1.08 (95 % CI 0. 63\u20131.84), medical vs. obstetric\/gynecology aOR 0.73 (95 % CI 0.37\u20131.43), <jats:italic>p<\/jats:italic> = 0.49].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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\u2010income countries should be accompanied by measurement of the nature and impact of this intervention.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3644-5","type":"journal-article","created":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T14:40:08Z","timestamp":1470753608000},"page":"2847-2856","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Retrospective Descriptive Study of an Intensive Care Unit at a Ugandan Regional Referral Hospital"],"prefix":"10.1002","volume":"40","author":[{"given":"Stephen S.","family":"Ttendo","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care Mbarara Regional Referral Hospital Mbarara Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Was","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Lucile Packard Children\u2019s Hospital at Stanford Palo Alto CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Preston","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Woman\u2019s Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Munyarugero","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Mbarara Regional Referral Hospital Mbarara Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa B.","family":"Kerry","sequence":"additional","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G.","family":"Firth","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital 55 Fruit Street 02114 Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,8,9]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61719\u2010X"},{"key":"e_1_2_7_3_2","volume-title":"World health report 2006: working together for health","year":"2006"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(10)60446\u20101"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318166ecb8"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756\u20100500\u20105\u2010475"},{"issue":"1","key":"e_1_2_7_7_2","first-page":"5","article-title":"A survey of the status of education and research in anaesthesia and intensive care medicine at the University Teaching Hospital in Lusaka, Zambia","volume":"13","author":"Jochberger S","year":"2010","journal-title":"Arch Iran Med"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102044.2006.04907.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20103156.2008.02202.x"},{"issue":"1","key":"e_1_2_7_10_2","first-page":"61","article-title":"Practice of intensive care in rural Africa: an assessment of data from Northern Uganda","volume":"8","author":"Towey RM","year":"2008","journal-title":"Afr Health Sci"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102044.2007.05295.x"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000208360.70835.87"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100229\u20106"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc9410"},{"key":"e_1_2_7_15_2","unstructured":"The World Factbook(2015)https:\/\/www.cia.gov\/library\/publications\/the\u2010world\u2010factbook\/fields\/2261.html. 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