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. 2023 May 29:17:11795565231169498.
doi: 10.1177/11795565231169498. eCollection 2023.

Survival Status and Predictors of Mortality Among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study

Amente Jorise Bacha  1 , Diriba Alemayehu Gadisa  2 , Mesay Dechasa Gudeta  3 , Tamirat Bekele Beressa  2 , Getandale Zeleke Negera  4
Affiliations

Survival Status and Predictors of Mortality Among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study

Amente Jorise Bacha et al. Clin Med Insights Pediatr. .

Abstract

Background: Advances in pediatric intensive care have dramatically improved the prognosis for critically ill patients. The study aimed to determine the survival status and predictors of mortality among patients admitted to the pediatric intensive care unit at selected tertiary care hospitals in Ethiopia.

Methods: A health facility-based prospective observational study from October 2020 to May 30, 2021, was conducted in a selected tertiary care hospital in Ethiopia. Kaplan Meier was used to compare patient survival experiences and Cox regression was used to identify independent predictors of ICU mortality. The hazard ratio was used as a measure of the strength of the association, and a P-value of <.05 was considered to declare statistical significance.

Results: Of 206 study participants, 59 (28.6%) patients died during follow-up time, and the incidence of mortality was 3.6 deaths per 100 person-day observation (95% CI: 2.04-5.04 deaths per 100 person-days). Respiratory failure 19 (32.2%) was the commonest cause of death followed by septic shock 11(18.6). In-ICU complications (AHR: 2.13; 95% CI: 1.02, 4.42; P = .04), sepsis diagnosis (AHR: 2.43; 95% CI: 1.24, 4.78; P = .01), GCS < 8 (AHR: 1.96; 95% CI: 1.12, 3.43; P = .02), use of sedative drugs (AHR: 2.40; 95% CI: 1.16, 4.95; P = .02) were linked with increased risk of in-ICU mortality. In contrast, the use of mechanical ventilation was associated with decreased mortality (AHR: 0.45; 95% CI: 0.21, 0.92; P = .03).

Conclusion: The study found a high incidence of in-ICU mortality among admitted pediatric patients in selected Ethiopian tertiary care hospitals. In-ICU complications, sepsis diagnosis, GCS < 8, and patient use of sedative drugs were independent predictors of in-ICU mortality. Prudent follow-up is warranted for those patients with the aforementioned risk factors.

Keywords: Ethiopia; Survival status; pediatric intensive care unit; predictors of mortality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Study flow chart (overview of the study participants).
Figure 2.
Figure 2.
Commonly prescribed specific medications during ICU stay among patients admitted to JMC and SPHMMC, from October 1 to May 30, 2021.
Figure 3.
Figure 3.
Outcome at discharge among patients admitted to JMC and SPHMMC, from October 1 to May 30, 2021.
Figure 4.
Figure 4.
Survival estimates for patients with complication and non-complicated after ICU admissions at JMC and SPHMMC, from October 1 to May 30, 2021.
Figure 5.
Figure 5.
Survival estimates for patients with GCS < 8 and GCS > 8 in ICU admissions at JMC and SPHMMC, from October 1 to May 30, 2021.
Figure 6.
Figure 6.
Survival estimates for patients with sepsis and non-sepsis diagnosis after at ICU of JMC and SPHMMC, from October 1 to May 30, 2021.
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