TIME TO DEATH AND PREDICTORS AMONG PATIENTS ADMITTED TO ADULT INTENSIVE CARE UNIT AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE; SURVIVAL RETROSPECTIVE COHORTS STUDY

Abstract

ABSTRACT Background: An intensive care unit serves for extremely ill patients manage by using life saving intervention. Many developing countries continue to experience high mortality of patients admitted to intensive care unit. Ethiopia has several hospitals with intensive care unit and the rate of mortality is varied from institution to institution. Objectives: To estimate median time to death and predictors among patients admitted to adult intensive care unit at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2022. Methods: A retrospective cohort study was conducted among 359 patients admitted to adult intensive care unit at St.paul’s Hospital Millennium College for 60 months. Data were collected from December 10, 2021 and December 30, 2021 by reviewing medical charts of patients who were admitted from July 1st 2016 - June 30th, 2021. EPI data version 4.6 were used for data coding, entering and Exported to STATA version 16 statistical software for analysis. Bivariable and multivariable Cox-proportional hazards regression analysis was used. The association between time to death and predictors verified with 95% confidence interval and P-value < 0.05. Schoenfeld Residuals used to check proportional hazard assumption. Result: A total of 359 admitted patients to adult intensive care unit were followed 2819 person- day. During the follow up period 155(43.17%) died making incidence rates of 55 (95%CI: 47, 64) per 1000-person day. Median time to death in adult intensive care unit was 13 (IQR: 4, 38). Shock (AHR:2.38(95%CI: 1.48,3.262) ,use of mechanical ventilation as intervention(AHR:0.24(95%CI:0.09,0.61),use of sedation as intervention (AHR:2.17(95%CI: 1.27,3.26) were predictors of admission to death at a P-value < 0.05). Conclusion: forty-three percent of admitted adult patients in the ICU had died with median time to death 13 days during the entire cohort. Shock, use of mechanical ventilation as intervention, use of sedation as intervention after admission were identified as a predictor of death among patients admitted to adult intensive care unit at St.paul’s Hospital Millennium College. Key words: Time to death, Predictor, Intensive Care Unit