Causes of admissions and in-hospital mortality among patients admitted to critical care units in primary and secondary hospitals in Vietnam in 2018: a multicentre retrospective study

Objective The goal of this study was to describe the burden of disease and in-hospital mortality among patients admitted to the critical care units (CCUs) in Vietnam. Design Retrospective study. Setting The whole 1-year data of admissions to CCUs were collected from 34 hospitals from January to December 2018. Participants A total of 44 013 episodes of admission to CCUs were analysed. Primary outcome We used International Classification of Diseases-11 codes to assess the primary diagnosis associated with admissions and in-hospitals mortality. Years of life lost (YLL) measure was further used to estimate the burden of disease. Results The 0-5 years and >= 70 years age groups accounted for 14.8% (6508/44 013) and 26.1% (11 480/44 013) of all admissions, respectively. The most common diagnoses were diseases of the respiratory system (27.8% or 12 255/44 013), followed by unclassified symptoms, signs or clinical findings (13% or 5712/44 013), and diseases of the circulatory system (12.2% or 5380/44 013). Among 28 311 patients with available outcome data, 1681 individuals (5.9%) died during the hospitalisation. The in-hospital mortality rate increased with age, from 2.8% (86/3105) in under 5 years old age group to 23.1% (297/1288) in over 90-year age group. Diseases of the respiratory system was the leading causes of death in term of number of deaths (21.8% or 367/1681 of all deaths). Diagnosis of sepsis was associated with the highest in-hospital mortality (36.8%). The overall YLL under the age of 75 were 1287 per 1000 patients. Conclusions CCUs in Vietnam faced wide differences in the burden of diseases. Sufficient infrastructure and adequate multidisciplinary training are essential to ensure the appropriate response to the current needs of population.