Abstract:
Background: Prolonged intensive care unit stay is a significant global public health issue,
associated with increased mortality, morbidity, and healthcare costs. Despite the
advancement in critical care, extended intensive care unit stay remains a problem, particularly
in resource-poor settings like Ethiopia. Identification of predictors of extended intensive care
unit stay and complications is important to maximize patient outcomes and resource
utilization.
Objective: This study aimed to assess determinants of prolonged intensive care unit stays
and their complications among adult patients admitted to the intensive care unit at Hiwot
Fana Comprehensive Specialized Hospital from October 01 2024 to September 29 2025.
Methods: An institutional-based cross sectional study design was employed at Hiwot Fana
Comprehensive Specialized Hospital. The data collection for this study took place from
September 5 to September 30 2025. Data was collected using a structured checklist and
medical records reviews. Data was analyzed using SPSS version 27. Descriptive statistics,
Bivariable and Multivariable logistic regression, were employed.
Results: Among 239 patients, the prevalence of prolonged ICU stay was 25.9%.
Multivariable analysis identified several independent predictors of prolonged stay: Age (AOR
= 1.02, 95% CI: 1.01–2.04, p = 0.031), those admitted from the Medical ICU (AOR = 7.50;
95% CI: 1.10–11.10), and patients presenting with High BP Stage 1 (AOR = 4.90; 95% CI:
1.55–15.45) on admission. Other significant independent predictors included comorbid
illnesses (AOR = 2.70; 95% CI: 1.90–3.20), the occurrence of complications during the stay
(AOR = 3.32; 95% CI: 1.41–7.80), a severely depressed GCS (AOR = 2.50; 95% CI: 1.15
5.45), and the requirement for mechanical ventilation (AOR = 2.50; 95% CI: 1.05–5.95).
Conclusion and Recommendations: In this study, the prevalence of prolonged ICU stay
was high, affecting approximately one-quarter of adult patients. Factors such as age, presence
of comorbidities, admission from the Medical ICU, severely depressed GCS, need for
mechanical ventilation, and development of in-ICU complications were significantly
associated with prolonged stay. As a result, the hospital should implement early screening
protocols for high-risk patients and strengthen preventive care to reduce complications and
optimize ICU bed utilization.
