{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T12:37:53Z","timestamp":1794659873011,"version":"4.9.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The burden of critical care is greatest in resource-limited settings. Intensive care unit (ICU) outcomes at public hospitals in Kenya are unknown. The present study is timely, given the Kenyan Ministry of Health initiative to expand ICU capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify factors associated with mortality at Moi Teaching and Referral Hospital and validate the Mortality Probability Admission Model II (MPM0-II).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of 450 patients from January 1, 2013, to April 5, 2015, was evaluated using demographics, presenting diagnoses, interventions, mortality, and cost data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICU mortality was 53.6%, and 30-day mortality was 57.3%. Most patients were male (61%) and at least 18 years old (70%); the median age was 29 years. Factors associated with high adjusted odds of mortality were as follows: age younger than 10 years (adjusted odds ratio [aOR], 3.59; P\u2009\u2264\u20090.001), ages 35\u201349 years (aOR, 3.13; P\u2009=\u20090.002), and age above 50 years (aOR, 2.86; P\u2009=\u20090.004), with reference age range 10\u201324 years; sepsis (aOR, 3.39; P\u2009=\u20090.01); acute stroke (aOR, 8.14; P\u2009=\u20090.011); acute respiratory failure or mechanical ventilation (aOR, 6.37; P\u2009&amp;lt;\u20090.001); and vasopressor support (aOR, 7.98; P\u2009&amp;lt;\u20090.001). Drug\/alcohol poisoning (aOR, 0.33; P\u2009=\u20090.005) was associated with lower adjusted odds of mortality. MPM0-II discrimination showed an area under the receiver operating characteristic curve of 0.78 (95% confidence interval, 0.72\u20130.82). The result of the Hosmer-Lemeshow test for calibration was significant (P\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a Kenyan public ICU, high mortality was noted despite the use of advanced therapies. MPM0-II has acceptable discrimination but poor calibration. Modification of MPM0-II or development of a new model using a prospective multicenter global collaboration is needed. Standardized triage and treatment protocols for high-risk diagnoses are needed to improve ICU outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201801-051oc","type":"journal-article","created":{"date-parts":[[2018,8,4]],"date-time":"2018-08-04T13:59:18Z","timestamp":1533391158000},"page":"1336-1343","source":"Crossref","is-referenced-by-count":55,"title":["Intensive Care Outcomes and Mortality Prediction at a National Referral Hospital in Western Kenya"],"prefix":"10.1093","volume":"15","author":[{"given":"Hussain S.","family":"Lalani","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangari","family":"Waweru-Siika","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Healthcare, Eldoret, Kenya"},{"name":"Department of Anesthesia, Aga Khan University Hospital, Nairobi, 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