The African Critical Illness Outcomes Study

NCT06051526 | Completed DMC

• 1 other identifier: ACIOS
• Study Type: observational
• Target: 20,159
• Locations: 1 country
• Sites: 1

Brief Summary

In Africa, the prevalence of critical illness is likely to be higher due to a greater burden of disease, and the associated mortality higher due to limited resources. This is a prospective, observational study to rapidly establish the prevalence of critical illness in in-hospital adult patients in Africa, and the resources available to provide essential critical care (care that should be available to every patient in the world) and factors associated with mortality. Rapid dissemination of these findings may help mitigate mortality from critical illness in Africa. These points provide the rationale for the African Critical Illness Outcomes Study.

Conditions

Critical Illness; Mortality

Outcome Measures

Primary Outcomes (2)

• Presence of critical illness

  The number of participants with critical illness.

  7 days

• In-hospital mortality (censored at 7-days)

  The number of participants with in-hospital mortality (censored at 7-days)

  7 days

Secondary Outcomes (3)

• Provision of essential emergency and critical care

  7 days

• Length of hospital stay

  7 days

• Number of essential emergency and critical care resources available for care

  7 days

Study Arms (1)

Critically ill in-patients

All adult inpatients in hospitals across Africa that are critically ill.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All adult patients aged 18 years or over who have been admitted for inpatient care in any department or ward in participating hospitals.

You may qualify if:

• All adult patients aged 18 years or over who have been admitted for inpatient care in any department or ward in participating hospitals.

You may not qualify if:

• None

Sponsors & Collaborators

• University of Cape Town: lead
• Muhimbili University of Health and Allied Sciences: collaborator

Study Sites (1)

Merowe Daman Hospital

Khartoum, Sudan

Location

Related Publications (33)

• Kayambankadzanja RK, Schell CO, Gerdin Warnberg M, Tamras T, Mollazadegan H, Holmberg M, Alvesson HM, Baker T. Towards definitions of critical illness and critical care using concept analysis. BMJ Open. 2022 Sep 5;12(9):e060972. doi: 10.1136/bmjopen-2022-060972.

  PMID: 36606666 RESULT

• Jenson A, Hansoti B, Rothman R, de Ramirez SS, Lobner K, Wallis L. Reliability and validity of emergency department triage tools in low- and middle-income countries: a systematic review. Eur J Emerg Med. 2018 Jun;25(3):154-160. doi: 10.1097/MEJ.0000000000000445.

  PMID: 28263204 RESULT

• Kruisselbrink R, Kwizera A, Crowther M, Fox-Robichaud A, O'Shea T, Nakibuuka J, Ssinabulya I, Nalyazi J, Bonner A, Devji T, Wong J, Cook D. Modified Early Warning Score (MEWS) Identifies Critical Illness among Ward Patients in a Resource Restricted Setting in Kampala, Uganda: A Prospective Observational Study. PLoS One. 2016 Mar 17;11(3):e0151408. doi: 10.1371/journal.pone.0151408. eCollection 2016.

  PMID: 26986466 RESULT

• Phua J, Faruq MO, Kulkarni AP, Redjeki IS, Detleuxay K, Mendsaikhan N, Sann KK, Shrestha BR, Hashmi M, Palo JEM, Haniffa R, Wang C, Hashemian SMR, Konkayev A, Mat Nor MB, Patjanasoontorn B, Nafees KMK, Ling L, Nishimura M, Al Bahrani MJ, Arabi YM, Lim CM, Fang WF; Asian Analysis of Bed Capacity in Critical Care (ABC) Study Investigators, and the Asian Critical Care Clinical Trials Group. Critical Care Bed Capacity in Asian Countries and Regions. Crit Care Med. 2020 May;48(5):654-662. doi: 10.1097/CCM.0000000000004222.

  PMID: 31923030 RESULT

• Maharaj R, Raffaele I, Wendon J. Rapid response systems: a systematic review and meta-analysis. Crit Care. 2015 Jun 12;19(1):254. doi: 10.1186/s13054-015-0973-y.

  PMID: 26070457 RESULT

• Kayambankadzanja RK, Likaka A, Mndolo SK, Chatsika GM, Umar E, Baker T. Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities. Malawi Med J. 2020 Mar;32(1):19-23. doi: 10.4314/mmj.v32i1.5.

  PMID: 32733655 RESULT

• Baker T, Lugazia E, Eriksen J, Mwafongo V, Irestedt L, Konrad D. Emergency and critical care services in Tanzania: a survey of ten hospitals. BMC Health Serv Res. 2013 Apr 16;13:140. doi: 10.1186/1472-6963-13-140.

  PMID: 23590288 RESULT

• Kayambankadzanja RK, Schell CO, Mbingwani I, Mndolo SK, Castegren M, Baker T. Unmet need of essential treatments for critical illness in Malawi. PLoS One. 2021 Sep 10;16(9):e0256361. doi: 10.1371/journal.pone.0256361. eCollection 2021.

  PMID: 34506504 RESULT

• Schell CO, Gerdin Warnberg M, Hvarfner A, Hoog A, Baker U, Castegren M, Baker T. The global need for essential emergency and critical care. Crit Care. 2018 Oct 29;22(1):284. doi: 10.1186/s13054-018-2219-2.

  PMID: 30373648 RESULT

• Crawford AM, Shiferaw AA, Ntambwe P, Milan AO, Khalid K, Rubio R, Nizeyimana F, Ariza F, Mohammed AD, Baker T, Banguti PR, Madzimbamuto F. Global critical care: a call to action. Crit Care. 2023 Jan 20;27(1):28. doi: 10.1186/s13054-022-04296-3.

  PMID: 36670506 RESULT

• Mekontso Dessap A, Richard JM, Baker T, Godard A, Carteaux G. Technical Innovation in Critical Care in a World of Constraints: Lessons from the COVID-19 Pandemic. Am J Respir Crit Care Med. 2023 May 1;207(9):1126-1133. doi: 10.1164/rccm.202211-2174CP.

  PMID: 36716353 RESULT

• Buowari DY, Owoo C, Gupta L, Schell CO, Baker T; EECC Network Group. Essential Emergency and Critical Care: A Priority for Health Systems Globally. Crit Care Clin. 2022 Oct;38(4):639-656. doi: 10.1016/j.ccc.2022.06.008.

  PMID: 36162903 RESULT

• Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, Colombara DV, Ikuta KS, Kissoon N, Finfer S, Fleischmann-Struzek C, Machado FR, Reinhart KK, Rowan K, Seymour CW, Watson RS, West TE, Marinho F, Hay SI, Lozano R, Lopez AD, Angus DC, Murray CJL, Naghavi M. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet. 2020 Jan 18;395(10219):200-211. doi: 10.1016/S0140-6736(19)32989-7.

  PMID: 31954465 RESULT

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  PMID: 26635210 RESULT

• Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Merisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015 Aug 8;386(9993):569-624. doi: 10.1016/S0140-6736(15)60160-X. Epub 2015 Apr 26. No abstract available.

  PMID: 25924834 RESULT

• Murthy S, Wunsch H. Clinical review: International comparisons in critical care - lessons learned. Crit Care. 2012 Dec 12;16(2):218. doi: 10.1186/cc11140.

  PMID: 22546146 RESULT

• Adhikari NK, Fowler RA, Bhagwanjee S, Rubenfeld GD. Critical care and the global burden of critical illness in adults. Lancet. 2010 Oct 16;376(9749):1339-46. doi: 10.1016/S0140-6736(10)60446-1. Epub 2010 Oct 11.

  PMID: 20934212 RESULT

• African COVID-19 Critical Care Outcomes Study (ACCCOS) Investigators. Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study. Lancet. 2021 May 22;397(10288):1885-1894. doi: 10.1016/S0140-6736(21)00441-4.

  PMID: 34022988 RESULT

• Ilori IU, Kalu QN. Intensive care admissions and outcome at the University of Calabar Teaching Hospital, Nigeria. J Crit Care. 2012 Feb;27(1):105.e1-4. doi: 10.1016/j.jcrc.2011.11.011.

  PMID: 22304993 RESULT

• Towey RM, Ojara S. Practice of intensive care in rural Africa: an assessment of data from Northern Uganda. Afr Health Sci. 2008 Mar;8(1):61-4. No abstract available.

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• Gombar S, Ahuja V, Jafra A. A retrospective analysis of obstetric patient's outcome in intensive care unit of a tertiary care center. J Anaesthesiol Clin Pharmacol. 2014 Oct;30(4):502-7. doi: 10.4103/0970-9185.142843.

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  PMID: 26154933 RESULT

• Baker T, Gerdin M. The clinical usefulness of prognostic prediction models in critical illness. Eur J Intern Med. 2017 Nov;45:37-40. doi: 10.1016/j.ejim.2017.09.012. Epub 2017 Sep 19.

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• International Surgical Outcomes Study group. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016 Oct 31;117(5):601-609. doi: 10.1093/bja/aew316.

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MeSH Terms

Conditions

Critical Illness

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Tim Baker, MBChB; PhD

  Muhimbili University of Health and Allied Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Co-chief Investigator

Study Record Dates

• First Submitted: September 1, 2023
• First Posted: September 25, 2023
• Study Start: September 1, 2023
• Primary Completion: January 3, 2024
• Study Completion: January 3, 2024
• Last Updated: April 10, 2024

Record last verified: 2024-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: Data will be available from the time of publication and for 10 years following publication.
• Access Criteria: Contributing researchers and collaborators

Locations

SU (1)