SURVIVAL STATUS AND PREDICTORS OF MORTALITY AMONG MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT AT ADDIS ABABA, ETHIOPIA, 2022: A ONE YEAR RETROSPECTIVE COHORT STUDY

Abstract

Abstract Background: Globally, potential demand for invasive mechanical ventilation is increasing, and the incidence of mortality among critically ill patients after mechanical ventilation support is reported to be high, though this is not exactly figured out yet in our country's context. However, there is limited data on the extent of the problem in Ethiopia. Therefore, this study aimed to investigate the survival status and predictors of mortality in mechanically ventilated patients who were admitted to the adult ICU of a governmental hospital in Addis Ababa, Ethiopia. Objective: The objective of this study was to determine survival status and predictors of mortality among mechanical ventilated patients in ICU, Addis Ababa, Ethiopia, from July 1, 2021, to June 30, 2022. Methods: A multicenter retrospective cohort study was conducted on 382 mechanically ventilated patient charts admitted to the adult ICU of four selected government hospitals in Addis Ababa, Ethiopia. Participants were selected by using simple random sampling techniques from March 1, 2023, to March 20, 2023. The data were entered into Epi Data Manager V4.2 and exported to Stata/MP V-14 for analysis. Bi-variable and multivariable Cox regression models were fitted in the analysis to determine the predictor variables. A hazard ratio (HR) with a 95% confidence interval (CI) was computed, and a p-value 0.05 was considered statistically significant. Results: The overall mortality among mechanically ventilated patients in the adult ICU was 67.0%, with an incidence rate of 9.23 cases (95% CI, 8.14–10.46) per 100 person-days of observation, and the median survival time was found to be 6 days. Increased systolic blood pressure (AHR = 2.11, 95% CI: 1.23, 3.61), elevated diastolic blood pressure (AHR = 0.25, 95% CI: 0.12, 0.53), HIV infection (AHR = 2.81, 95% CI: 1.62, 4.88), GCS at the end of follow-up (AHR = 19.29, 95% CI: 8.46, 43.99), serum albumin (AHR = 0.66, 95% CI: 0.46, 0.96), and creatinine level (AHR = 1.17, 95% CI: 1.12, 1.35) were found to be significantly associated with mortality of mechanically ventilated patients in the adult ICU. Conclusions and Recommendation: The mortality rate of mechanically ventilated patients in the adult ICU was high. Blood pressure, HIV infection, GCS, serum albumin, and creatinine level were the identified predictors of mortality in my study. Further prospective study in the future is needed, with the inclusion of other important predictive variables like malnutrition, body mass index, smoking habit and others, is advocated for better result. Keywords: Survival, Predictors, Mortality, Mechanical ventilator, Retrospective cohort.