Abstract:
Objective To determine the incidence and predictors
of mortality among children admitted to the paediatric
intensive care unit (PICU) at the University of Gondar
comprehensive specialised hospital, northwest Ethiopia.
Design A single-centre
prospective observational cohort
study.
Participants A total of 313 children admitted to the ICU
of the University of Gondar comprehensive specialised
hospital during a one-and-
a-
half-
year
period.
Measurements Data were collected using standard case
record form, physical examination and patient document
review. Clinical characteristics such as systolic blood
pressure, pupillary light reflex, oxygen saturation and
need for mechanical ventilation (MV) were assessed and
documented within the first hour of admission and entered
into an electronic application to calculate the modified
Pediatric Index of Mortality 2 (PIM 2) Score. We fitted the
Cox proportional hazards model to identify predictors of
mortality.
Result The median age at admission was 48 months
with IQR: 12–122, 28.1% were infants and adolescents
accounted for 21.4%. Of the total patients studied, 59.7%
were males. The median observation time was 3 days with
(IQR: 1–6). One hundred and two (32.6%) children died
during the follow-up
time, and the incidence of mortality
was 6.9 deaths per 100 person-day
observation. Weekend
admission (adjusted HR (AHR)=1.63, 95% CI: 1.02 to 2.62),
critical illness diagnoses (AHR=1.79, 95% CI: 1.13 to
2.85), need for MV (AHR=2.36, 95% CI: 1.39 to 4.01) and
modified PIM 2 Score (AHR=1.53, 95% CI: 1.36 to 1.72)
were the predictors of mortality.
Conclusion The rate of mortality in the PICU was high,
admission over weekends, need for MV, critical illness
diagnoses and higher PIM 2 scores were significant and
independent predictors of mortality.
