The modern intensive care medicine emerged during the Polio epidemics in the 1950s, which was pioneered by a Danish anesthetist, Bjorn Ibsen at the Kommune hospital of Copenhagen in 1953[1, 2].
The Intensive Care Unit (ICU) is a specially staffed, well equipped, separate, and self-contained area of a hospital dedicated to providing aggressive therapy using state-of-the-art technology and both invasive and noninvasive monitoring for critically ill and high-risk patients[3-6].
The burden of life-threatening conditions requiring management in the intensive care unit has grown substantially in the last couple of decades in low and middle-income countries because of an emerging pandemic, motorization, urbanization, and hospital expansion[7-12]. However, the advancement of ICU care is very limited in these countries due to the high cost of infrastructure, training medical staff, failure to incorporate international guidelines for evidence-based care, and availing medical supplies[9, 11, 13-16].
Intensive care unit comprises of only 10 percent of hospital bed but it costs more than 30 percent of acute hospital care which is equivalent to 20 percent of the hospital budget and this cost becomes higher in a patient with a severe critical illness which hinders the low resource setting to establish intensive care units[3, 17].
Critical ill patients are admitted to ICU for some reasons including but not limited to respiratory failure, severe infectious diseases, multiple trauma and shock, myocardial infarction, heart failure, renal failure, poisoning, postoperative care, and therapeutic[18-37].
Evidence showed that the incidence of ICU admission ranged from 1 to 54% globally [17, 35, 37-40]. The cause of ICU admission is not consistent across the globe and the majority of available evidence showed that cardiovascular and respiratory disorders were the commonest causes of admission in middle and high-income countries accounting for 27 to 41% of admission[17, 35, 37-40] while trauma and postoperative care were the main reasons for ICU admission in low-income countries which varied from 10 to 50%[6, 37, 38, 41].
Evidence revealed that the outcomes of patients in ICU is greatly related to different factors including but not limited to the pattern of diseases, the severity of the disease, infrastructure, trained medical staff, nursing care, medical supplies, age of patient, presence of comorbidities and multiorgan failure, pre-hospital and emergency care trauma score, mechanical ventilation, length of ICU stay, complications in ICU, dissemination of antimicrobial-resistant microorganisms and inappropriate or suboptimal use of antibiotics[6, 9, 18, 24-28, 30, 34, 36, 37, 40-48].
The global prevalence of mortality in ICU roughly ranges from 9 to 61%. An international study recruiting 13, 796 participants from Africa, Asia, America, Europe, and Oceania revealed that the prevalence of mortality in ICU was 18.2%.
Other evidence from Sub-Saharan Africa showed that mortality in ICU was ranged from 27% to 61% [38, 41, 50, 51]. A systematic review and meta-analysis by Vincent et al showed that ICU mortality related to septic shock in Europe and North America was 37.3% (95% CI:35.5 to 43.5%).
The mortality is very high in the low-income country which is as high as 61% as compared to developed countries which varied from 9 to 18%[28, 38, 41, 50, 51, 53].
The rate of ICU mortality in Ethiopia varied from region to region ranging from 27 to 38% [4, 6, 28, 32, 46, 53]. However, the pattern of disease and predictors of mortality in the Southern part of Ethiopia is not well investigated. This multicenter observational study was designed to investigate the pattern of disease and predictors of mortality in selected Southern Ethiopia ICUs.