Original Research

Outcomes 30 days after ICU admission: the 30DOS study

Robert Wise, Kim de Vasconcellos, David Skinner, Reitze Rodseth, Dean Gopalan, David Muckart, Zohra Banoo, Tashmin Bisseru, Steve Blakemore, Jenine de Meyer, Michael Faurie, Kom Govender, Timothy Hardcastle, Prakash Jeena, Nicky Kalafatis, Kroshlan Kistan, Theroshnie Kisten, Carolyn Lee, Colin Mitchell, Magesvaran Moodley, Mary Morgan, Arisha Ramkilliwana, Rajesh Ramjee, Darshan Reddy, Afke Robroch, Shivani Singh, Richard von Rahden, Bruce Biccard
Southern African Journal of Anaesthesia and Analgesia | Vol 23, No 6 | a1084 | DOI: https://doi.org/10.1080/22201181.2017.1402553 | © 2017 Robert Wise, Kim de Vasconcellos, David Skinner, Reitze Rodseth, Dean Gopalan, David Muckart, Zohra Banoo, Tashmin Bisseru, Steve Blakemore, Jenine de Meyer, Michael Faurie, Kom Govender, Timothy Hardcastle, Prakash Jeena, Nicky Kalafatis, Kroshlan Kistan, Theroshnie Kisten, Carolyn Lee, Colin Mitchell, Magesvaran Moodley, Mary Morgan, Arisha Ramkilliwana, Rajesh Ramjee, Darshan Reddy, Afke Robroch, Shivani Singh, Richard von Rahden, Bruce Biccard | This work is licensed under Other
Submitted: 17 November 2025 | Published: 30 December 2017

About the author(s)

Robert Wise, Pietermaritzburg Metropolitan Department of Anaesthetics, Critical Care and Pain Management, Pietermaritzburg, South Africa; and, Clinical Unit, Critical Care, Edendale Hospital, Pietermaritzburg, South Africa; and, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Kim de Vasconcellos, Clinical Unit, Critical Care, Edendale Hospital, Pietermaritzburg, South Africa; and, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
David Skinner, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Reitze Rodseth, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Dean Gopalan, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
David Muckart, Discipline of Surgery, University of KwaZulu-Natal, Durban, South Africa
Zohra Banoo, KwaZulu-Natal Department of Health District, Ethekweni Paediatric Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Discipline of Paediatrics, University of KwaZulu-Natal, Durban, South Africa
Tashmin Bisseru, Paediatrics, Life Hilton Hospital, Pietermaritzburg, South Africa
Steve Blakemore, Aneasthesiology, St Augustine’s Hospital, Durban, South Africa
Jenine de Meyer, Inkosi Albert Luthuli Central Hospital, National Health Laboratory Services, Durban, South Africa; and, Clinical Unit, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
Michael Faurie, Discipline of Surgery, University of KwaZulu-Natal, Durban, South Africa
Kom Govender, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Timothy Hardcastle, Clinical Unit, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Trauma Service, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Trauma Training Unit, University of KwaZulu-Natal, Durban, South Africa
Prakash Jeena, Paediatric Intensive Care Unit, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
Nicky Kalafatis, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Critical Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
Kroshlan Kistan, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Theroshnie Kisten, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Critical Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
Carolyn Lee, Internal Medicine, Pietermaritzburg, South Africa; and, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Colin Mitchell, Pietermaritzburg Metropolitan Department of Anaesthetics, Critical Care and Pain Management, Pietermaritzburg, South Africa; and, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Magesvaran Moodley, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Mary Morgan, Discipline of Paediatrics, University of KwaZulu-Natal, Durban, South Africa; and, Paediatrics, Pietermaritzburg Metropolitan Hospitals Complex, Pietermaritzburg, South Africa
Arisha Ramkilliwana, Pietermaritzburg Metropolitan Department of Anaesthetics, Critical Care and Pain Management, Pietermaritzburg, South Africa; and, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Rajesh Ramjee, Anaesthesiology, Prince Mshiyeni Memorial Hospital, Durban, South Africa
Darshan Reddy, Department of Cardiothoracic Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Afke Robroch, Wilhemina’s Childrens Hospital, UMC, Utrecht, the Netherlands
Shivani Singh, Discipline of Paediatrics, University of KwaZulu-Natal, Durban, South Africa; and, Paediatric Critical Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
Richard von Rahden, Discipline of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Intensive Care Unit, Grey’s Hospital, Pietermaritzburg, South Africa
Bruce Biccard, Department of Anaesthesia and Perioperative Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

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Abstract

Background: The spectrum of illness and long-term outcome of critically ill patients admitted to intensive care units (ICUs) in South Africa remains largely unknown.
Objectives: This study was designed to provide data on ICU outcomes and disease burden in public sector ICUs in KwaZuluNatal. The primary objective was to describe 30-day mortality of all patients admitted to participating sites. Secondary objectives included clinical demographics and spectrum of illness amongst these patients, and testing a template to demonstrate feasibility of such data collection.
Methods: 30DOS was a multicentre, prospective, observational cohort study conducted over 30 days. An a priori decision was made to report study results separately for adults and paediatric patients. This article reports the results for adult patients. The complete 30-DOS study included 11 ICUs in six hospitals. All adult patients admitted to study ICUs were included. Patients were followed up telephonically by a research assistant. Data on patient demographics, preadmission functional scoring, injury severity scoring, co-morbidities, admission diagnosis/es, organ support, and outcome were collected.
Results: A total of 228 adults were included. The majority of admissions (73.7%) occurred on an emergency basis, with 68.4% occurring in the postoperative period. Approximately half were for non-communicable disease (49.6%), followed by trauma (29.0%) and infectious disease (21.5%). There were a total of 59 (25.9%) deaths within the first 30 days after admission. In-ICU mortality was 19.7%. There were 12 (5 3%) in-hospital deaths following discharge and two (0.9%) out-of-hospital deaths. Thirtyday survival was known for 174 (76.3%) admissions with a 33.9% mortality rate.
Conclusion: Overall in-ICU mortality was 19.7% with a large trauma burden in a young population. Thirty-day mortality was 33.9%. Information pertaining to patient demographics and spectrum of illness provided novel information to further the understanding of the demand placed on critical care resources within South Africa.

Keywords

critical care; 30-day mortality; outcome; South Africa

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