Background Shock is a common emergency condition which can lead to organ failure and death if not diagnosed and managed timely. Despite its huge global impact, data is scarce in resource-limited settings, such as Ethiopia, which hinders the provision of quality care for improved patient outcomes. Hence, the aim of the study was to determine the incidence of death and predictors among adult patients with shock managed at the Emergency Department of St. Paul’s Hospital Millennium Medical College in Ethiopia.

Methods A retrospective chart review study was conducted between July to September 2022 among 178 eligible adult patients who were managed at hospital between October 2021 and May 2022. The characteristics of the participants were summarized using frequency and median with interquartile range. The incidence of mortality was estimated using incidence density using person hour (PH) of observation. To identify predictors of mortality, a generalized linear model using poisson regression model with robust standard errors was run at 5% level of significance, where adjusted relative risk (ARR) with its 95% CI was used to interpret significant results

Result The incidence of death was 6.87 deaths per 1000 PH (95% CI= 5.44 to 8.69). Significant predictors of death were being triaged orange (ARR=0.46, 95% CI=0.24-0.88, p=0.020), having a high shock index (ARR=1.59, 95% CI=1.07-2.36, p=0.021), being diagnosed with septic shock (ARR=3.66, 95% CI=1.20-11.17, p=0.023), taking vasopressors (ARR=3.18, 95% CI=1.09, 9.27, p=0.034), and developing organ failure (ARR=1.79, 95% CI=1.04-3.07, p=0.035).

Conclusion The incidence of mortality among shock patients was found to be considerable but relatively lower than previous studies. To optimize patient care and improve outcomes, it is important to remain vigilant in the proper triage and early diagnosis of shock using more sensitive tools for prompt identification of high-risk cases, as well as to provide timely, prioritized and effective interventions.

The authors have declared no competing interest.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was carried out after obtaining ethical approval from the institutional review board of St. Paul's Hospital Millennium Medical College (SPHMMC-IRB). The St. Paul's Hospital Millennium Medical College institutional review board (SPHMMC-IRB) also waived the need for informed consent since the study used secondary data (Ref. No. PM23/62). The study was carried out in accordance with relevant guidelines and regulations. Confidentiality of the patient's information contained within their registration books, cards, and referral papers were assured by using of medical record number and omitting any personal identifiers. Furthermore, access to the collected information was limited to the investigators.

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All relevant data are available upon reasonable request from Kalsidagn Girma Asfaw at Kalsidagn.asfawgmail.com.