DETERMINANTS OF PROLONGED ICU STAY AND ASSOCIATED COMPLICATIONS AMONG ADULTS AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL: A CROSS-SECTIONAL STUDY

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.