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Published on: January 16, 2019
Post-ICU Outcomes in a Low-Resource Setting: A Cohort Study From Rwanda
Geofrey Bahati1, Wellars Niragire, Faustin Niyonshuti
1All authors: Division of Clinical Services, Department of Anaesthesia and Critical Care, Rwanda Military Teaching Hospital, University of Rwanda, Kigali, Rwanda.
Importance:
Survivorship after critical illness in low-resource settings is inadequately characterized.
Objectives:
To assess 90-day mortality and multidimensional recovery following ICU discharge.
Design, Setting, And Participants:
Prospective cohort of adults discharged alive from a national referral ICU in Rwanda.
Main Outcomes And Measures:
Mortality, functional status (Modified Barthel Index), cognition (Mini-Mental State Examination), and anxiety and depression (Generalized Anxiety Disorder-7, Patient Health Questionnaire-9).
Results:
Among 62 participants (mean age 41 ± 16 yr; 50% male), 90-day mortality was 12.9%. By day 90, only 48.4% achieved full functional independence, while 36.8% remained impaired. Normal cognition increased from 22.6% at discharge to 51.6% at follow-up. Notably, 30.6% of survivors reported severe anxiety or depression.
Conclusions And Relevance:
ICU survivorship in this low-resource setting is marked by substantial persistent morbidity. These findings underscore critical gaps in post-ICU care and the urgent need for scalable, context-appropriate survivorship strategies.
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