PATTERN OF ADMISSION, TREATMENT OUTCOME AND ASSOCIATED FACTORS AMONG ADULT SHOCK PATIENTS IN EMERGENCY DEPARTMENT OF HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background: Shock, a state of circulatory insufficiency, disrupts the balance between tissue oxygen delivery and consumption, causing end-organ dysfunction. Four categories of shock are classified based on physiological changes. Unfortunately, studies on shock patterns and treatment outcomes in emergency setups are lacking in the developing world, particularly in Eastern Ethiopia. Objectives: To determine pattern of admission, treatment outcome and associated factors of shock at adult emergency department of Hiwot Fana Comprehensive Specialized Hospital from January 1st, 2021 to December 31st 2022. Methods: Institution based cross-sectional study was conducted in 204 randomly selected patients who have been presented with shock or developed shock at Emergency department of Hiwot Fana Comprehensive Specialized Hospital. Simple random sampling technique was used and data were collected using structured standardized checklist. The collected data were entered into Epidata version 3.8 and exported to the statistical package for Social Science Version 25 for analysis. All variable that has a P-value less than 0.25 in the Bivariable analysis were entered for multivariable analysis and said to be significantly associated if the P-value is less than 0.05 and the strength of association was presented by an adjusted odd ratio with a 95% confidence interval. Result: Among the 204 charts analyzed, the majority of the patients were female (53.4%). Distributive shock was the most common type of shock, with 128 patients (62%) affected. Septic shock presented among 46.1% of patients and 52% of the patients had underlying comorbidities. The mortality rate due to shock in this study was 27.9% (57). Patients with septic shock (Adjusted Odds Ratio 4.54, CI: 1.56-13.16), organ failure (Adjusted Odds Ratio 3.31, CI: 1.25-8.72), comorbidities and shock (Adjusted Odds Ratio 5.17, CI: 1.73-15.45), and those triaged as "red” (Adjusted Odds Ratio 5.93, CI: 1.58-22.30) had high odds of death. Conclusion: The mortality rate among patients suffering from shock was high; particularly those with septic shock, organ failure, comorbidities, and a "red" triage classification. Prompt diagnosis and comprehensive management of underlying factors like hypertension and diabetes are vital for better outcomes and reduced mortality in the emergency department.