Post-Operative Mortality Prevalence and Associated Factors Among Adult Patients Admitted to Surgical Ward in Hiwot Fana Comprehensive Specialized Hospital:

Retrospective Cross-Sectional Study

Abstract

Background: Post-operative mortality is a critical factor in evaluating the quality of surgical care and its outcomes within healthcare facilities. No surgical procedure is without risk, as complications following surgery can lead to disability, extended hospital stays, or even death. Despite increasing research on post-operative mortality in Ethiopia, significant gaps remain especially regarding the Harari Region. Although national statistics offer a broad overview, locally focused studies are essential to inform targeted interventions.

Methods: A retrospective cross-sectional study design was employed from January 10 to February 10, 2025. A total of 602 participants were selected using a simple random sampling technique. Data were collected using Kobo Toolbox and subsequently exported to SPSS statistical software for analysis. Variables that showed associations in the bivariate analysis were entered into multivariate logistic regression. Statistical significance was determined at a p-value < 0.05, with adjusted odds ratios and 95% confidence intervals reported. Model fitness was evaluated using the Hosmer and Lemeshow goodness-of-fit test, and multicollinearity was assessed via the Variance Inflation Factor.

Results: This study shows that, prevalence of post-operative mortality in Hiwot Fana Comprehensive Specialized Hospital (HFCSH) was 14 (2.3%). The odds of death among patients with a low platelet count were five times higher (AOR = 5.71; 95% CI: 1.12, 29.17) than those with normal platelet counts. Similarly, the odds of death among patients admitted to the ICU were fourteen times higher (AOR = 14.45; 95% CI: 3.22, 64.70) than those not admitted to the intensive care unit.

Conclusion: The magnitude of postoperative mortality in this study was higher than the global average but lower than that reported in some African countries and national studies. ICU admission and low platelet count were significantly associated with increased postoperative mortality. These findings emphasize the need for thorough preoperative assessments particularly focusing on platelet count and underscore the importance of providing optimal care in the ICU to improve surgical outcomes.