Epidemiology and outcomes of critically ill
patients in the emergency department of a
tertiary teaching hospital in Rwanda

Dublin Core

Title

Epidemiology and outcomes of critically ill
patients in the emergency department of a
tertiary teaching hospital in Rwanda

Subject

Emergency care, LMIC, Critical care, Resuscitation, Rwanda

Description

Abstract
Background The introduction of Emergency Medicine in Rwanda in 2015 has been associated with a mortality
reduction in patients presenting to Kigali University Teaching Hospital (KUTH). In the context of increasing numbers
of critically ill patients presenting to Emergency Departments (ED) globally, the aim of this study was to describe
the characteristics of critically ill patients, the critical care interventions performed, and the outcomes of critically ill
patients presenting to the KUTH ED with the goal of informing future research into the root causes of mortality of
critically ill ED patients and of identifying high yield topics for didactic and procedural training.
Methods A descriptive observational prospective cohort pilot study analyzed all patients ≥15 years who presented
to KUTH between April and June 2022 with modified South African Triage Scores of Red with alarm, Red without
alarm, and Orange.
Results Of 320 patients, 66.9% were male and median age was 40 years. Patients were triaged as Orange (65.3%),
Red without alarm (22.8%), and Red with alarm (11.9%). Presentations were categorized as: medical emergencies
(48.0%), traumatic injury (44.5%), and surgical emergencies (7.6%). Median length of stay was 31 h (IQR 28, 56)
and boarding was 23 h (IQR 8, 48). Overall mortality was 12.2% and highest among medical emergencies (16.5%,
p=0.048) and increased significantly with triage color: Red with alarm (47.4%), Red without alarm (16.4%), and Orange
(4.3%, p<0.0001). Cardiopulmonary resuscitation (CPR) (10.3%), endotracheal intubation (8.8%), and vasopressor
administration (3.1%) were the most frequent critical interventions performed. Survival after cardiac arrest was 9.1%
and 32.1% after intubation. Mortality was associated with the following interventions: CPR, intubation, and use of
vasopressors (p<0.05).
Conclusions This pilot study identified the most common critical care interventions performed and a high mortality
among patients who required these interventions in the ED of a tertiary teaching hospital in Rwanda. These findings
will inform didactics and procedural training for emergency care providers. Future research should focus on the

Creator

Laurent Gamy Kamunga B.1,2*, Courtney J. Bearnot3,4, Kyle D. Martin4*, Doris L. Uwamahoro1
and Giles

N. Cattermole1,5

Source

https://doi.org/10.1186/s12245-024-00736-9

Date

2024

Contributor

Peri Irawan

Format

pdf

Language

english

Type

text

Files

Citation

Laurent Gamy Kamunga B.1,2*, Courtney J. Bearnot3,4, Kyle D. Martin4*, Doris L. Uwamahoro1 and Giles N. Cattermole1,5, “Epidemiology and outcomes of critically ill
patients in the emergency department of a
tertiary teaching hospital in Rwanda,” Repository Horizon University Indonesia, accessed April 12, 2026, https://repository.horizon.ac.id/items/show/12493.