ICU sedation, delirium & recovery
The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa
Errata to this article were published (Lancet, 12 Apr 2025 ↗ · 20 Sep 2025 ↗)
Main finding · Critical illness (prevalence) and in-hospital mortality (7-day)Result — go to the resultAdjusted odds ratio 7.72 CI 6.65–8.95Authors' conclusion
One in eight patients in hospitals in Africa are critically ill, of whom one in five dies within 7 days. Most critically ill patients are cared for in general wards, and most do not receive the essential emergency and critical care treatments they require.
Study context
- Population
- Inpatients aged ≥18 years, regardless of location, in acute hospitals across Africa (180 hospitals, 22 countries or territories), September–December 2023
- Participants
- 19,872 inpatients · 180 hospitals
- Exposure
- Critically ill vs non-critically ill inpatients
- Outcome
- Coprimary: critical illness and 7-day mortality
- Follow-up
- 7 days
Methodological detailsinternational, prospective
- International
- Prospective
Main finding
As reported in the abstract
Critical illness (prevalence) and in-hospital mortality (7-day)
Adjusted odds ratio
7.72
CI 6.65–8.95
Events by group
Critically ill vs non-critically ill inpatients
aOR 7.72 (CI 6.65–8.95)
- Critically ill on census day
- 2461/19 743 (12.5%)
- Critically ill cared for in general wards
- 1688/2459 (68.6%)
- Overall deaths
- 967/19 780 (4.9%)
Observational data: associations, not effects.
Further findings
Location of care of critically ill
- Cared for in general wards
- 1688/2459 (68.6%)
Essential treatments received by critically ill
- Respiratory failure receiving oxygen
- 557/1151 (48.4%)
- Circulatory failure receiving IV fluids or vasopressors
- 521/965 (54.0%)
- Low conscious level receiving airway intervention or recovery position
- 387/784 (49.4%)
Original publication
The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa. Lancet. Published 1 March 2025. doi:10.
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