Descriptive analysis of the causes and outcomes of patients admitted to intensive care unit in Gaza during June 2024: A prospective cohort study

Since the onset of the 2023 Israel–Gaza war, the healthcare system in the Gaza Strip has nearly collapsed. More than 70,937 casualties and 171,192 injuries have been reported, yet limited data exist on injury types and outcomes. Critical care services are essential during conflicts. This study aimed to determine causes of intensive care unit (ICU) admissions, associated injuries, complications, and outcomes in the Gaza Strip. We conducted a prospective cohort study of all adult and pediatric patients admitted to the ICUs at European Gaza Hospital and Shuhada Al-Aqsa Hospital between May 29 and June 30, 2024. Outcomes of interest were causes of admission, survival, types of complications, and length of stay. A total of 115 patients were admitted. Median age was 27 years (interquartile range 18–38), including 30 pediatric patients (26%). Thirty-five patients were female (30%). Trauma with or without burns accounted for 75 admissions (65%), while 27 (23.5%) had medical causes. Among trauma patients, 56 (75%) were from explosive injuries; traumatic brain injury was most common (30/75, 40%), including 10 of 21 pediatric trauma patients (47.6%). During ICU stay, 12 patients developed sepsis (10.6%), 10 developed septic shock (8.8%), and 12 developed multiorgan dysfunction (10.6%). Of 112 patients with known disposition, 64 were discharged and 48 died (43%). Median ICU survival was 6 days (95% confidence interval 5–17), and 17 days for pediatric patients (95% confidence interval 5–not calculable). Severe traumatic brain injury (33%) was the leading cause of death, followed by septic shock (22%). The high burden of trauma, complications, and mortality reflects the critical collapse of Gaza’s healthcare system. Women and children represented a substantial proportion of ICU patients, highlighting civilian vulnerability. Urgent international medical intervention, humanitarian support, and a permanent ceasefire are essential to prevent continued loss of life.