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Home > Investigating Mpm-Iii, Sofa and Delta Sofa Scoring Systems As Predictors of Mortality at a Tertiary Hospital in Nairobi, Kenya: A Retrospective Cohort Study

Investigating Mpm-Iii, Sofa and Delta Sofa Scoring Systems As Predictors of Mortality at a Tertiary Hospital in Nairobi, Kenya: A Retrospective Cohort Study

Thesis Info

Author

Lukoko, Lilian

Department

Anaesthesiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728054614

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Background: Despite major advances, management of critically ill patients worldwide is associated with high mortality rates. Assessment of disease severity is crucial in the analysis of ICU mortality. Although a variety of severity of illness scoring systems have been developed for this assessment and validated across Europe and the USA, few studies exist to show support of their utilization in African countries. There is conflicting evidence regarding the most reliable severity of illness scoring system suitable for resource limited countries as their mortality predictive values differ with different populations. SOFA is already in use at the AKUHN ICU and has easily attainable variables, while MPM-III is a simple, non-laboratory test dependent scoring system. Objectives: The primary objective of this study was to compare SOFA and MPM-III severity of illness scoring systems as predictors of mortality in critically ill adult patients admitted to the AKUHN ICU. Secondary objectives were to describe the clinical and demographic characteristics of patients admitted to the AKUHN ICU, to identify factors associated with increased risk of mortality in patients admitted to the AKUHN ICU, to compare MPM-III and delta SOFA scoring systems as predictors of mortality in critically ill adult patients admitted to the AKUHN ICU and to compare SOFA and delta SOFA scoring systems as predictors of mortality in critically ill adult patients admitted to the AKUHN ICU. Primary outcome: ICU mortality Study setting: AKUHN ICU. Study design: A retrospective cohort study. Sample size: Using a formula for determining statistical difference between two areas under receiver operating characteristic curves, a sample size of 543 was used. Study population: Critically ill adult patients admitted to the AKUHN ICU between January 2015 and September 2017. Data collection and entry: The ICU admission register was used to obtain the names and medical records of patients admitted during the study period. A comprehensive review of patients’ files and the AKUHN Electronic Medical Records System (CARE®) was then conducted to extract data as per the data collection tool. MPM-III scores were calculated using an online MPM-III scoring calculator. Data was entered into an MS Excel spreadsheet to form a database. STATA software version 14.2 was used for data analysis. Results: Male patients accounted for 60% of total admissions. The most common reason for admission was respiratory failure at 33%. Medical and surgical admissions constituted 61% and 39% of the total admissions respectively. Mortality rate was 32.4%. Median LOS was 4
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اقبال سہیل

اقبال سہیلؔ
افسوس ہے کہ گزشتہ مہینہ اقبال سہیلؔ بھی چل بسے ۔وہ مسلم یونیورسٹی علی گڑھ کے باقیاتِ صالحات اور اُس عہد کی دیرینہ روایات کے حاملین میں سے تھے۔غیر معمولی ذہین وذکی تھے ۔فارسی اور اردو دونوں زبانوں کے بلند پایہ شاعر تھے۔ وہ اگر وکیل نہ ہوتے یامزاج لااُبالی نہ ہوتا توعلم وادب کے میدان میں ان کی شہ سواری کا مقابلہ بہت کم لوگ کرسکتے تھے ۔طبیعت حددرجہ دقیقہ رس اور دماغ بڑا نکتہ آفریں پایاتھا۔ نغز گوئی کے ساتھ اشعار میں روانی غضَب کی ہوتی تھی۔ غزلوں اور نظموں کے علاوہ انھوں نے جو نعتیہ نظمیں لکھی ہیں وہ بھی بڑے معرکہ کی ہیں، نثر بھی بہت اچھی لکھتے تھے ۔اگر کوئی صاحب اُن کے مضامین ِ نثر و نظم کو مرتب کرکے یک جا شائع کردیں تویہ اردو ادب کی مفید اورلائقِ قدر خدمت ہوگی۔ورنہ ان ادبی جواہر پاروں کے ضائع ہوجانے کا اندیشہ ہے ۔حق تعالیٰ مغفرت وبخشش کے فضل ِ خاص سے نوازے ۔ [دسمبر۱۹۵۵ء]

 

فقہی احکام کے استنباط میں علت کا کردار

The Quran is the complete code of life and the fountainhead of guidance for all peoples till the last Day. When the Quran itself does not speak directly or in detail about a certain subject, Muslims only then turn to alternative sources of Islamic Law is this way the companions of the Prophet Muhammad (BPUH) would asking Him when they were not able to find a specific legal ruling in the Quran in spite they were Arabians. With the passage of time slowly gradually new issues and problems are to be faced by peoples in different times. Sometimes the companions & the followers not only salved those issues & problems in the light of Quran & Sunnah, but also played a significant role in such cases. To find the solution of any problem in the light of primary sources of Islam is called Etiology. Etiology has a significant role in the Sharia’s sources of analogy. To illustrate this, analogical reasoning can be viewed in this article.

The Job Satisfaction of District Officers

Organizations expect involvement and commitment from their workforce to create esprit de corps for the realization of corporate as well as individual objectives. However, worker’s attitude (involvement and commitment) depends on his/her satisfaction from different aspects of the organization as related to the employees. Employee’s satisfaction or ‘Job Satisfaction’ therefore determines the degree to which a worker will be involved in and committed to any job/work. Several organizational dimensions have been identified as the predictors of job satisfaction but pay, work, supervision, promotion, work environment and co-workers are widely researched independent variables that have been studied over and over again (job-related factors). In the background of these instant variables, organizational structure, policies and broader social context play dominant role in the variation of job satisfaction (organization related variables). Finally, the personal characteristics of employees are also responsible to explain the job satisfaction of the workers in any organization (personal features). Job satisfaction is the degree of match and mismatch between whatever is expected by the employee from the organization and what he/she gets in reality. The worker expectations are the motivators which, if fulfilled, motivate the employee to get involved and show commitment. Thus, what motivates a worker is the predictor of his job satisfaction. According to the Maslow’s hierarchy of needs, job satisfaction of those employees who need to meet their primary needs depends on the fulfillment of primary motives. And those at the higher levels of motivation can be satisfied only when their8/193 higher level motives like status, recognition, and self-actualization are addressed by the organization. For example, workers with high level motives cannot be motivated or satisfied with the fulfillment of low level needs. One who needs high profile status cannot feel happy (neither motivated nor satisfied) with an increase in pay only. Although job, organization and person related variables are universal in their existence as predictors of job satisfaction however, they all ‘read’ differently from person to person, job to job, organization to organization and location to location. The same factors operate in every study of job satisfaction but their impact on workers’ contentment and performance vary significantly in multiple manners. Given this, neither the same explanation/definition can portray all the situations nor the single solution model can be implemented everywhere. There is need to understand every individual organizational situation separately in terms of job, organization and person related factors. These factors hold unique attributes in every employee and work situation and must be tapped by the researchers so that a ‘local’ definition of ‘job satisfaction’ could be developed to figure out a ‘domesticated solution’ for addressing satisfaction problems. A huge research is going on to explore the issue of job satisfaction of top management or executives, managers, supervisors, and the staff in different countries, organizations and situations. The findings from developed and developing nations match in several aspects but they also differ in many dimensions. For example, in advanced countries, high level motivation factors are more responsible for job satisfaction than in the developing states9/193 where job satisfaction still depends more heavily on the primary and middle level of factors of motivation. To cut short, the understanding of ‘job satisfaction’ as an issue for developing countries (in public or private sector organizations) is only possible if local research is conducted to record the nature, intensity and variety of job, organization and employee related characteristics. This local knowledge can give real touch of the ‘native problem’ thereby enabling the concerned researchers and authorities to sort out a real picture of the problem. Furthermore, the localized version of the problem is only logical option for devising a solution that is compatible with the local work attitudes and environment. The research shows that there is big variation between the job satisfaction of public and private sector employees with common belief that public sector employees are less satisfied than those working in private organizations. Similarly, job satisfaction varies within public organizations across different departments. Abdul Sattar Khan PhD scholar in Management Studies Department of Public Administration, GU, DIK, KPK, Pakistan