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Preoperative anaemia and its impact on immediate surgical outcomes in elderly patients: a multicentre prospective cohort study in Ethiopia

Por: Wubet · H. B. · Gobezie · N. Z. · Deress · G. M. · Mekuriaw · B. Y. · Abuhay · A. G. · Afework · W. A. · Siyoum · T. M. · Gedefaw · G. D. · Abate · A. T. · Demissie · B. · Demtie · D. G. · Asmare · T. B.
Objective

To assess how preoperative anaemia affects surgical outcomes in elderly patients within a resource-limited setting.

Design

Prospective cohort study.

Setting

Two comprehensive specialised hospitals in Ethiopia.

Participants

Participants consisted of 224 patients aged 65 years and older who underwent surgery between 1 December 2024 and 29 March 2025.

Primary and secondary outcome measures

Perioperative blood transfusions were the primary outcome. Secondary outcomes included intensive care unit (ICU) admission, risk of postoperative complications, prolonged hospitalisation, poor recovery quality and in-hospital mortality.

Results

The anaemic group required transfusions of three or more units more frequently than the non-anaemic group (10.5% vs 2.6%; absolute risk difference 8.0%). Their perioperative transfusion rates were significantly higher (42.3% vs 18.4%; p

Conclusion and recommendation

Preoperative anaemia significantly increases the risk of transfusion, poor recovery, ICU admission, prolonged hospitalisation and in-hospital mortality in older patients who underwent surgery. In resource-limited settings, improving perioperative outcomes should prioritise the early detection and treatment of anaemia.

Preconception care uptake and risk factors for adverse pregnancy outcomes among pregnant women in Tigray, northern Ethiopia: A community-based cross-sectional study

by Gebremedhin Gebreegziabher Gebretsadik, Andargachew Kassa Biratu, Alemayehu Bayray Kahsay, Amanuel Gessessew, Zohra S. Lassi, Hailemariam Segni, Afework Mulugeta

Background

Adverse pregnancy outcomes continue to pose a significant global public health challenge, especially in low- and middle-income countries. Although preconception care (PCC) interventions are advised to address this problem, their adoption remains inadequate, supported by scarce evidence particularly in conflict-impacted areas such as Tigray, Ethiopia, where rates of poor outcomes like neural tube defects are notably higher than in other regions. This study investigates the experience of pregnant women regarding the use of PCC in the Tigray, northern Ethiopia.

Methods

A community-based cross-sectional study was conducted from July 31 to August 16, 2024, involving 764 pregnant women in their first or second trimester. Participants were consecutively enrolled from clusters until the predetermined sample size was achieved. Data were collected through interviewer-administered questionnaires in accordance with World Health Organization, and Centers for Disease Control and Prevention, and national guidelines. PCC uptake was measured as the receipt of any service component (screening, counseling, or management) during healthcare consultations. We used SPSS version 27.0 to analyze PCC uptake and its associated factors. Descriptive and binary logistic regression statistics were used in the analysis. Finally, data was presented using text, tables, and figures as appropriate.

Results

In this study, the overall uptake of PCC services was 7.2%. All participants in the current pregnancy were exposed to at least one risk factor for adverse pregnancy outcomes. Factors such as women’s decision-making power, having information about PCC, HIV screening during the current pregnancy, and perceived susceptibility to preconception risks showed a statistically significant positive association with the uptake of PCC services.

Conclusion

The uptake of PCC services was very low. Addressing the low uptake of PCC services requires a multifaceted strategy, including public health campaigns via media and social forums, strengthened health extension programs, and the integration of a reproductive life plan tool to improve health-seeking behavior among women.

Incidence and predictors of delirium in patients admitted to intensive care unit at comprehensive specialised hospitals in Amhara region, northwest Ethiopia: a multicentre prospective observational study

Por: Asmare · T. B. · Wubet · H. B. · Gobezie · N. Z. · Deress · G. M. · Belete · K. G. · Tadesse · M. A. · Abuhay · A. G. · Demissie · B. · Melesew · A. A. · Afework · W. A. · Alle · Y. F. · Demite · D. G. · Teshome · D. · Mossie · K. D. · Kassa · B. D. · Gedefaw · G. D.
Objective

To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025.

Design

A multicentre prospective observational study was conducted.

Setting

Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025.

Participants

A total of 351 patients were included in the final analysis during the study period.

Outcome measures

The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units.

Results

The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) ≥1) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium.

Conclusion and recommendation

In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS≥1) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.

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