Survival Status and its predictors among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study

Survival Status and its predictors among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Survival Status and its predictors among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study Amente Jorise Bacha, Diriba Alemayehu Gadisa, Getandale Zeleke Negera This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1658360/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Advances in pediatric intensive care have radically improved the prognosis for critically sick patients. Despite high burden of critically ill patients in low-income countries, there is scarce evidence on the incidence of mortality and its predictors among patients admitted to Intensive care unit (ICU) in Ethiopia. Therefore, we designed this study to determine the survival status and predictors of mortality among patients admitted to pediatric ICU at selected tertiary care hospitals in Ethiopia. Methods: A prospective observational study involving 206 admitted patients from October 2020 to May 30, 2021 was conducted in selected tertiary care hospital in Ethiopia. Data were collected on socio-demographic, clinical characteristics, treatment-related variables and entered into Epi-data version 4.6, and then exported to SPSS version 23.0 for analysis. Kaplan-Meier was used to compare the survival experience of the patients and Cox regression was used to identify independent predictors of in-ICU mortality. The hazard ratio was used as a measure of the strength of association and a p-value of < 0.05 was considered to declare statistical significance. Results: Fifty-nine (28.6%) patients were died during follow-up time, and the incidence of mortality was 3.6 deaths per 100 person-day observation. The mean ± SD survival times among patients with infectious and non-infectious related illnesses were 19.96 ± 1.84 and 27.24 ± 2.52 days respectively (log rank p = 0.08). Respiratory failure 19 (32.2%) was the commonest cause of death. In-ICU complications (AHR: 2.13; 95%CI: [1.02, 4.42]; p = 0.04), sepsis diagnosis (AHR: 2.43; 95%CI: [1.24, 4.78]; p = 0.01), GCS<8 (AHR: 1.96; 95%CI: [1.12, 3.43]; p = 0.02), use of sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p = 0.02) 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 = 0.03). Conclusion: The study found high incidence of in-ICU mortality among admitted pediatrics 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 aforementioned risk factors. Survival status Predictors of mortality Pediatric Intensive Care Unit Ethiopia Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Intensive care is a multi-disciplinary and inter-professional specialty committed to the management of patients with serious organ dysfunction (1). The PICU is a specifically staffed, separate, and independent area in the health care facilities dedicated to the broad manage m ent of patients with critical illnesses to reduce mortality by strictly monitoring and treating severely ill patients who are considered to be at high risk of death (1,2). Regardless of significant improvement in decreasing child mortality, worldwide childhood mortality rates remain high and children continue to face extensive regional disparities in their chances of existence(3). The WHO report shows that the major causes of pediatric death in developing countries are preventable and curable diseases if treatment is optimized (4,5). The prevalence of PICU mortality was varied in developed and developing countries, which is very high in the low-income countries (6–10) as compared to high-income countries (11–13). In the United States (US), the primary causes of mortality among under-five children were congenital anomalies and accidental injuries, But in unindustrialized countries, most childhood mortality were due to infections such as pneumonia, diarrhea, and severe malaria(2). Advances in pediatric intensive care have radically enhanced the prognosis for critically ill patients, but pediatric critical care services were reasonably young in developing countries and children’s mortality remains a major health problem; particularly in Sub-Saharan Africa (SSA) with varying qualities and quantities of infrastructure necessary for the provision of suitable critical care services(14). In 2020 alone, SSA remains to be the region with the highest under-five mortality rate, which accounts for 53% of all under-five deaths globally (3,15). Studies conducted in Mozambique, Rwanda and Eritrea showed that mortality rates in the ICU were found to be high which were 25%, 50% and 25.3%, respectively (9,16,17). Ethiopia is one of the top five countries with the world's highest under-five mortality rates, which accounts for 59 deaths per 1000 live births (4,18). Based on available findings , pediatric ICU is where the utmost number of mortality happens in the most hospitals of Ethiopia and studies conducted in Ethiopia reported that the overall mortality rate of patients admitted to pediatric ICU was 8.5%, 32.6%, and 39.8% with the most common cause of death being neurologic disorders, infections, and cardiovascular disease, respectively (6,10,19). Despite of the high burden of critically ill children in developing countries and while PICU is an essential area of service to save the lives of patients with acutely life-threatening conditions; organizational details of pediatric ICUs in low-income settings and available data on pediatric intensive care, specifically on the incidence of mortality, and its predictors among patients admitted to PICU in our country remain insufficient. Also, most of the existing evidence of mortality in the pediatric ICUs were limited to single-center, revised patient medical charts retrospectively (6,8,10,19,20). In Ethiopia, there are a small number of pediatric ICUs established for the pediatric patients and in addition to that; there is an inadequate resource to provide care for critically ill patients. This makes the establishment of adequate service and enhancement of outcomes difficult. So, there is a great need to conduct an extensive study on the hospitals based, particularly ICU basis to obtain reliable information on this area. Therefore, the aims of this study was to determine the incidence of mortality and its predictors among patients admitted to selected tertiary care hospitals in Ethiopia. Methods And Participants Study design, period, and setting An institutional-based prospective observational study was conducted among pediatrics patients admitted to the PICU at Jimma Medical Center (JMC), and St. Paul’s Hospital Millennium Medical College (SPHMMC) from October 2020 to May 2021. JMC is the teaching and referral hospital in southwest Ethiopia located in Jimma town and it provides services for over 20 million catchment population. Currently, the hospital has more than 600-bed capacities, and its PICU has four beds with electronic monitors and mechanical ventilators for patients admitted from different departments of the hospital. SPHMMC is a tertiary care hospital located in Addis Ababa, the capital city of Ethiopia. It is one of the largest government hospitals in the nation and its core services included the provision of medical care, teaching, and research. The hospital gives for patients coming from Addis Ababa and all over Ethiopia. Currently, the hospital has more than 750 beds, of these; the PICU has six beds with electronic monitors and mechanical ventilators for patients admitted to PICU. Source and study population All pediatric patients admitted to the pediatric ICU of JMC and SPHMMC were our source population, while pediatric patients admitted to the pediatric ICU during the study period that fulfilled the inclusion criteria were our study population. Study Variables Dependent Variables Survival statuss at PICU discharge (ICU mortality) Independent Variables Age, gender, residence, weight, patient category, nutritional and vaccination status, source of admission, frequency of admission, the reason for admission presence of comorbid illness, mental status, organ dysfunction, intervention during ICU stay, PIM2 score, and length of ICU stay, and caregiver’s related factors. Eligibility criteria All pediatric patients who were admitted to the PICU of JMC and SPHMMC during the study period were included, while those who died on arrival or died within two hours of admission and patients who had inadequate data were excluded. Sample Size Determination and Sampling procedures The sample size for this study was calculated using a single population proportion formula where, No = minimal sample size required, z = 1.96 (normal deviate corresponding to 95% confidence interval), w = 0.05 (degree of precision of 5%), p = 0.326 (a mortality rate of 32.6%; from study conducted in Ethiopia (10). Since the target population was less than 10,000, then the exact sample size was adjusted as; nf = No/1+No/N, nf is the corrected sample size and N is obtained from the previous admission data from two hospitals (SPMMC = 229, JMC = 186), which was 415. Then, by adding a 10% contingency value, the final sample size was 206 patients. Based on the previous admissions, this number was proportionally divided for both hospitals in the ratio of 1:1.24. Accordingly, 92 and 114 patients were allocated for JMC and SPHMMC, respectively. A consecutive sampling technique was used and all consecutively admitted patients to PICU from October 2020 to May 2021 were included, based on the inclusion criteria. Data collection Tools and Procedures To ensure content validity, the data collection tool was adapted from previous related studies and patient charts were examined as per the objectives of the study. The data were collected by one bachelor nurse and one clinical pharmacist recruited from each department who was working at SPHMMC and JMC after taking assent from the caregivers. Training on data collection was given for data collectors before beginning the data collection. Clinical character such as SBP, pupillary light reflex; oxygen saturation, and need for mechanical ventilation (MV) were assessed within the first hour and entered into an electronic application to calculate the Pediatric Index of Mortality 2 (PIM2) Score (21). Data Quality Assurance Before the actual data collection, the questionnaire adapted from previous studies was translated to the local official languages (Amharic and Afan Oromo), and then back to the English version to ensure the data content. A pretest was done on 5% of a sample before the actual data collection to check the consistency and validity of the structured data collection format. The collected data were double-checked by the data collector and the principal investigator for completeness, accuracy, and clarity. Data processing and Analysis Data were checked manually for completeness, and entered into Epi-data manager version 4.6 and then sent to SPSS version 23 for statistical and survival analysis. Descriptive analysis was performed to recap baseline characteristics, and results were presented by the text, tables, and figures. Kaplan-Meier curves were computed to compare the survival status of patients. Bivariate analysis was conducted and variables having a p-value < 0.25 were considered as candidates for multi-variable regression. Multi-variable cox proportional hazard model was performed to identify factors associated with in-ICU mortality. The hazard ratio was used as a measure of the strength of association and variables with a p-value of < .05 were reflected to declare statistical significance. Operational definitions Pediatric Intensive Care Unit – is a specially staffed, separate, and self-contained area in the hospital dedicated to the detailed management of critically ill patients (1,2). In-ICU mortality: is defined as all-cause ICU mortality from index admission to discharge ascertained by death summary from healthcare records/physicians Event (death): is the cessation of all biological function that sustains an organism (patient who died in the hospital during on treatment). Censored : It refers to patients who were discharged alive from the pediatric ICU. In-ICU complications are patient who develops other conditions during their ICU stay. Length of ICU stay: refer to the duration of ICU stay in days from the date of admission to the date of discharge from pediatric ICU Clinical outcome : It’s the outcome of the patient until he or she leaves the hospital. Pediatric Index of Mortality (PIM2) score : is a mortality prediction tool that considers data on the type of admission (elective or emergency), diagnosis risk, mechanical ventilation, systolic blood pressure, base excess by blood PH, arterial oxygen pressure, and pupillary examination data within the first hour of ICU admission (21). Results Out of 217 consecutive patients admitted to pediatric ICU of JMC and SPHMMC over eight months period, 206 patients were included. Of these patients enrolled, eleven patients were excluded (age < 1 month = 4, died < 2 hours of ICU admission = 5, parent’s reject assent = 2). Finally, data of 206 patients were included in the study. A majority, 114 (55.3%) of the patients were from SPHMMC. Of patients analyzed, 179 (86.9%) patients were medical and 27 (13.1%) with surgical admissions ( Figure1 ) Socio-demographic characteristics Of patients admitted, 113 (54.9%) were female, giving a male to female ratio of 1:1.22. The mean ± SD age of the patients admitted in ICU was 55.99±54.93 months. More than half, 124 (60.2%) of the patients were from a rural area, and 94 (45.6%) patients were admitted from the pediatric emergency department. Of all the patients analyzed, 38 (18.4%) were severely malnourished (<–3 Z-score). The majority of patients were medical patients, which accounted for 179 (86.9%) and 157 (76.2%) were new admissions. Regarding the vaccination status, 120 (58.3%) was fully vaccinated. The majority, 185 (89.8%) of the caregivers were parents and 80 (38.8%) had no formal education and around 94 (45.6%) of them were farmers ( Table1 ) Clinical Characteristics of admitted Patients The most common cause for ICU admission was severe pneumonia, 35 (17%), followed by septic shock 32 (15.5%), and complicated meningitis 25 (12.1%) ( Table2 ). Regarding the consciousness level of patients at arrival to the ICU, 52 (25.2%) patients were presented with severe impairment of consciousness. One hundred twenty-two (59.2%) patients had oxygen saturation 5 scores. More than two-thirds, 142 (68.9%) of patients were mechanically ventilated. The median length of stay in the PICU was 5 (IQR: 3–9) days and the majority, 104 (50.5) of patients were died within 7 days of ICU admission. Forty-eight patients (23.3%) developed complications during their ICU stay ( Table 3 ). Type of Treatment Given During PICU Stay Of medication prescribed in pediatric ICU, almost all patients were treated with different types of antibiotics 185 (89.8%), followed by fluid resuscitation 158 (76.7%), analgesics, 109 (52.9%), and nutritional treatments ( Table 4 ). Majority, 149 (72.3%) of the patients were treated with ceftriaxone followed by vancomycin 71 (34.5%), morphine 68 (33%), and metronidazole 63 (30.6%) ( Figure 2 ). Survival status of admitted patients In-ICU mortality : During the study period, 59 (28.6%) patients died, and the incidence of mortality was 3.6 deaths per 100 person-day observations One hundred forty-seven (71.4%) patients were survivors, among them the majority 76 (51.7%) were improved and transferred to the wards ( Figure 3 ). The (mean ±SD) survival times among patients admitted with infectious and non-infectious related diseases were 19.96 ±1.84, and 27.24 ± 2.52 days respectively (log-rank p= 0.08) ( Figure 4 ). The commonest causes of death were respiratory failure, 19 (32.2%), followed by septic shock, 11 (18.6%), cardiac arrest, 9 (11.9%), multi organ failure 7(11.9%), and complicated meningitis, 6 (10.1%) ( Table 5 ). Predictors of in-ICU mortality Cox regression was done to identify the association between baseline characteristics and in-ICU mortality. Accordingly, sepsis diagnosis, sex, infectious disease, organ dysfunction, need of mechanical ventilator, PIM2 score, patient use of sedative drugs, Oxygen saturation at admission, antibiotics use, GCS at admission, and complications in the ICU had a p-value of < 0.25. With a multivariate cox proportional hazard regression modeling, complications in the ICU (AHR: 2.13; 95%CI: [1.02, 4.42]; p = 0.04), sepsis diagnosis (AHR: 2.43; 95%CI: [1.24, 4.78]; p = 0.01), GCS<8 (AHR: 1.96; 95%CI: [1.12, 3.43]; p = 0.02), use of sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p= 0.02) were linked with increased risk of in-ICU mortality. The use of mechanical ventilation was associated with decreased mortality (AHR: 0.45; 95%CI: [0.21, 0.92]; p = 0.04). Then, the hazard of mortality was two times higher for patients who developed complications in pediatric ICU (AHR: 2.13; 95%CI: [1.02, 4.42]; p= 0.04) as compared with non-complicated patients. Also, the hazard of mortality was 2.40 times higher in patients who used sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p = 0.01) as compared with non-users of sedative drugs. Mortality was 55% lower for those who use mechanical ventilators during their ICU stay than non-users of MV (AHR: 0.45; 95%CI: [0.21, 0.92]) ( Table 6 ). Discussion This study assessed the survival status and its predictors among patients admitted to pediatric ICU patients treated at two selected Ethiopian tertiary care hospitals. Our study is the first report from a two-center prospective observational study in a PICU in Ethiopia that demonstrates the mortality is high and identified predictors of mortality such as complications in the ICU, use of sedative drugs, sepsis diagnosis, GCS < 8 and use of mechanical ventilator. In this study, the overall in-ICU mortality was 28.6% with an incidence of 3.63 deaths per 100 person-day observations. This finding is consistent with the mortality rate in the studies conducted in Pakistan, (26.6%) (22), Egypt, (33.1%) (23), Mozambique, (25%) (7), Eritrea, (25.3%) (16) and Gonder (Ethiopia), (32.6%) (10). However, it is lower than the finding of a retrospective cross-sectional study done in Jimma (Ethiopia) from 2009 to 2013, (40%) (8). The difference could be attributed to the higher proportion of trauma patients admitted in their PICU compared with ours. Furthermore, the proportion of mortality in our PICU is higher than the finding of a study conducted in Ayder Referral Hospital (Ethiopia), Iran, Pakistan, Nepal, and India (8.5%, 16.5%, 11.9%, 12.6%, and 14%), respectively (6,11,24–26). The higher proportion of deaths in our setting could be explained by the fact that this is tertiary center, which accepts referrals from distant locations resulting in delayed presentation, and most of the patients were seriously ill when admitted to our setting. This may be due the insufficient mechanical ventilator in our setting for those in need. In addition, the lack of a high dependency unit in the study area might be one of the contributing factors for the higher rate of ICU mortality. A higher proportion of death was reported among patients with infectious diseases (17.9%) versus non-infectious (10.7%). This finding is in line with most of the studies conducted in developing countries, in which more than half of deaths were attributed to infectious diseases (7,9,10,27). However, several findings from developed countries reported non-infectious disease as the most common cause of death (11–13). This could be because of low socio-economic, poor hygiene, and inaccessibility of health care facilities in developing settings. Our study showed that respiratory failure was the leading cause of death accounting for (32.2%) of total death, followed by septic shock (18.6%), cardiac arrest (11.9%), and complicated meningitis (10.1%). This finding is comparable with the study conducted in Mozambique, Gonder (Ethiopia), Iran, Bangladesh, and India (7,10,11,27,28). In contrary to our finding, the leading cause of death was the withdrawal of life-sustaining treatments in the study done in the US, (13), trauma in a study done in Jimma (8), and renal failure in study conducted in Eretria (16). This difference might be due to differences in study design, the pattern of admission, and the ICU service provided. The mean (± SD) length of stay in PICU was 7.87 ± 7.86 days with (59.7%) of patients stayed within 2 to 7 days of ICU admission in our study. This finding is consistent with the study done in Rwanda (6.8 ± 8.5 days) (9), and Nepal (6.29 days) (29), but on contrary to a study done in Pakistan (4.11 ± 1.88 days) (22). The difference in mean length of stay might be due to variation in admission pattern, the quality of care delivered to the patients in ICU, and in-ICU complications might be one of the contributing factors for the higher length of ICU stay in our setting. This study also identified the independent predictors of in-ICU mortality. Hence, the presence of in-ICU complications, sepsis diagnosis, GCS < 8, and use of sedative drugs were found to be independent predictors of mortality at the PICU, while the use of a mechanical ventilator was associated with a lower risk of mortality. Patients who developed complications during their ICU stay were two times more likely to die than those without compilations (p = 0.04). There is no published study for comparison purposes. But, this could be since complications are associated with an increased probability of death because of a double burden on initial illnesses. This study indicated that the hazard of mortality was 2.40 times higher in patients who took sedative drugs (p = 0.02). This is comparable with the study conducted in Rwanda (9), Greece, (11), and Harvard children’s hospital, Boston (30); the use of the sedative drug was correlated with increased risk of in-ICU mortality. This might be due to sedation leaves the patient at risk of needing prolonged respiratory support, specifically mechanical ventilator, prolonged ICU stays, and it also put critically ill patients at high risk of developing PICU-acquired complications (9,11,30). Children admitted with reduced level of consciousness (GCS < 8) had nearly two times increased risk of mortality than those admitted with higher. This is consistent with the findings of studies done in Iran (11). The child who had a sepsis diagnosis had an increased hazard of mortality than those who had not. This finding was consistent with other studies conducted in Iran (31). This could be because of patients with severe sepsis have a low spare of physiologic function. The in-ICU mortality was 55% lower for those who use mechanical ventilators during their ICU stay than non-users. This finding is contrasting with a study conducted in TASH (19), and Gonder (Ethiopia) (10), in which the use of mechanical ventilator was significantly correlated with an increased risk of in-ICU mortality. The possible justification that use of MV was associated with reduced risk of death in our study might be related to the fact that severe pneumonia which could lead to Acute Respiratory Distress Syndrome (ARDS) was the commonest cause of admission and most patients with ARDS benefit from MV. Though this study is a two center prospective study conducted in resource limited country, it has some limitations. First, the income of caregivers that might affect the survival status of pediatric patients was not assessed because it was difficult to ascertain since the majority of admissions were from a rural area and they usually under-report the assets they have. Secondly, PIM2 scoring was based on 8 out of 10 parameters as there was no arterial blood gas analyzer in our PICU during the study period. Finally, sample size is small and it may affect power of the study. Conclusion The study found high incidence of in-ICU mortality among pediatrics patients in selected Ethiopian tertiary care hospitals. Respiratory failure, septic shock and cardiac arrest were the common causes of admission and death. In-ICU complications, sepsis diagnosis, GCS < 8, and use of sedative drugs were linked with increased risk of in-ICU mortality in contrast to the use of mechanical ventilator. Therefore, prudent follow up is warranted for those patients with aforementioned risk factors. Abbreviations AHR : Adjusted Hazard Ratio ARDS : Acute Respiratory Distress Syndrome CHR : Crude Hazard Ratio CI : Confidence Interval EOPD : Emergency Outpatient Department ETT : Endotracheal Tube GBS : Gillian Barre Syndrome GCS : Glasgow Coma Scale ICU : Intensive Care Unit IQR : Inter Quarter Range JMC : Jimma Medical Center LOS : Length of Stay MV : Mechanical Ventilation PICU : Pediatric Intensive Care Unit PIM2 : Pediatric Index of Mortality 2 SD : Standard Deviation SPHMMC : Saint Paul’s Hospital Millennium Medical College SPSS: Statistical Package of Social Science SSA: Sub-Saharan Africa TASH : Tikur Anbesssa Specialized Hospital US : United States WHO : World Health Organization Declarations Ethics approval and consent to participate The study was done in accordance with the declaration of Helsinki. An ethical clearance letter was obtained from the institutional review board of Jimma University ( reference No: IRB000234/2012) and St. Paul’s Hospital Millennium Medical College (reference No: PM23/200). Then, a letter of cooperation was taken from each pediatrics and child health department of the hospital. Informed verbal consent was gotten from the caretakers. The name of patient was not recorded on the data collection form, and all information taken from the chart was kept strictly confidential and the data retrieved was used only for the study. Consent for publication Not applicable. Availability of data and materials Full data for this research is available through the corresponding author up on request. Competing interests The authors declare that they have no competing interests. Funding None Authors’ contributions All authors contributed to the design of the study and the interpretation of data. AJB: also performed the data collection, statistical analysis and drafted the manuscript. All others authors critically revised the manuscript. All authors read and approved the final manuscript. Acknowledgements We would like to thank Jimma University for facilitating conducive environment for the research. We also would like to express our deepest heartfelt thanks to Jimma Medical Center and St. Paul’s Hospital Millennium Medical College for providing available information. Finally, our special thanks go to the study participants, data collectors and supervisors. References Marshall J et. al. What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2017;37:270–6. Kliegman. et al. Nelson Textbook of Pediatrics. 21 edition. Elsevier; 2017. 1–36 p. UN Inter-agency Group for Child Mortality. Levels & Trends in childhood mortality. In: WHO Report 2020. 2020. p. 1–56. Riviello ED, Letchford S, Achieng L and NM. Critical care in resource poor settings: lessons learned and future directions. Crit Care Med. 2011;39(4):860–7. Vincent JL, Marshall JC, Ñamendys-Silva SA, François B, Martin-Loeches I, Lipman J, et al. Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations audit. Lancet Respir Med. 2014;2(5):380–6. H. Haftu, T. Hailu, A. Medhaniye TG. Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia. BMC Res Notes. 2018;11:339. Punchak, M., Hall, K., Seni, A., Chris Buck, W., DeUgarte, D. A., Hartford, E., … Muando VI. Epidemiology of Disease and Mortality from a PICU in Mozambique. Pediatr Crit Care Med. 2018;19(11):E603–10. Abebe, T., Girmay, M., G/Michael, G., & Tesfaye M. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital. Int J Gen Med. 2015;8(63):63–7. Nyirasafari R, Corden MH, Karambizi AC, Kabayiza JC, Makuza JD, Wong R, et al. Predictors of mortality in a paediatric intensive care unit in Kigali, Rwanda. Paediatr Int Child Health. 2017;37(2):109–15. Teshager NW, Amare AT, Tamirat KS. Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: A prospective observational cohort study. BMJ Open. 2020;10(10):1–7. Valavi, E., Aminzadeh, M., Shirvani, E., Jaafari, L., & Madhooshi S. The main Causes of mortality in pediatric intensive care unit in South west of Iran. Zahedan J Res Med Sci. 2018;20(4):1–4. Volakli E, Sdougka M, Tamiolaki M, Tsonidis C, Reizoglou M, Giala M. Demographic profile and outcome analysis of pediatric intensive care patients. Hippokratia. 2011;15(4):316–22. Jeffrey P. Burns, Deborah E. Sellers, Elaine C. Meyer, Mithya Lewis-Newby and RDT. Epidemiology of Death in the Pediatric Intensive Care Unit at Five U.S. Teaching Hospitals. Crit Care Med. 2014;42(9):1–17. Adedokun ST YS. Childhood morbidity and its determinants: Evidence from 31 countries in sub-Saharan Africa. BMJ Glob Heal. 2020;5(e003109):1–10. WHO. Newborns: improving survival and well-being. Vol. 1990, World Health Organisation. 2020. p. 9–12. Mohammed M, Tekle S. Patterns And Treatment Outcomes of Pediatric Intensive Care Unit Admissions In 2013 , Orotta National Referral Hospital. Int J Pharm H Care Res. 2020;8(4):27–33. Ongóndi M, Mwachiro M, Ranketi S. Predictors of mortality in a critical care unit in south western Kenya. Ann Afr Surg. 2016;13(1):3–6. Ethiopian Public Health Institute (EPHI) [Ethiopia] and ICF. Ethiopia Mini Demographic and Health Survey. In: Rockville, Maryland, USA: EPHI and ICF. 2019. p. 47–53. Asmamaw Abebe, Yafet Noah He. Disease Pattern, Outcome And Associated Factor of Patient Admitted In Pediatric Intensive Care Unit At Tikur Anbessa Specialized Teaching Hospital. 2019 (unpublished article); Ashenafi T, Tilahun BC, Heye TB. Admission pattern and outcome in a pediatric intensive care unit of gondar university hospital. Ethiop Med J. 2019;57(2):111–5. Vivek V. Shukla SMN, Ajay G. Phatak and JDG. Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India. Int J Pediatr. 2014;8(27):1–7. Qamar uz Zaman Khan, Faisal Basheer, Zameer Ahmad Nayyar AIB. Clinical profiles and outcomes in pediatric intensive care unit of a tertiary care hospital in Pakistan. Pak Armed Forces Med J. 2020;70(6):1657–61. Rady HI. Profile of patients admitted to pediatric intensive care unit , Cairo University Hospital. Ain-Shams J Anesthesiol. 2014;5(6):500–3. Haque, A., Siddiqui, N. R., Jafri, S. K., Hoda, M., Bano, S., Mian A. Clinical profiles and outcomes of children admitted to the pediatric intensive care unit from the emergency department. J Coll Physicians Surg Pakistan,. 2015;25(4):301–3. Shah GS, Shah BK, Thapa A, Shah L, Mishra OP. Admission Patterns and Outcome in a Pediatric Intensive Care Unit in Nepal. Br J Med Med Res. 2014;4(30):4939–45. Maheswari K. et.al. Clinical Profile and Outcome of Patients Admitted to Pediatric Intensive Care Unit of a Tertiary Care Teaching Hospital in Eastern India. J Med Sci Clin Res. 2018;6(9):1289–3. Hoque, M., Alam, S., & Ahmed A. Admission pattern and outcome in a paediatric intensive care unit of a tertiary care paediatric hospital in Bangladesh – A two-year retanalysis. JJournal Bangladesh Coll Physicians Surg. 2014;4(2):134–9. Mukhija DG, Chandra DS, Prasad DP. Clinical profile of patients admitted to the PICU of a tertiary care teaching hospital. Int J Pediatr Res. 2017;4(2):125–7. Shrestha AK, Bhattarai S, Paudel P, Basel PL. Morbidity and mortality pattern of patients admitted into paediatric intensive care unit of tertiary level hospital of Nepal. J Nepal Paediatr Soc. 2020;40(1):28–33. Egbuta C MK. Current State of Analgesia and Sedation in the Pediatric Intensive Care Unit. 2021;10(9):18–47. Aljabari S, Balch A, Larsen GY et al. Severe sepsis-associated morbidity and mortality among critically ill children with cancer. 2019;8:122–9. Tables Table 1 Socio-demographic characteristics among patients admitted to PICU of selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021, (N=206). Socio demographic variables Outcome n (%) Frequency (%) P-value Died Survived Study site JMC 27 (29.3) 65 (70.7) 92 (44.7) 0.86 SPHMMC 32 (28.1) 82 (71.9) 114 (55.3) Sex Female 30 (26.5) 83(73.5) 113 (54.9) 0.25 Male 29 (31.2) 64 (68.8) 93 (45.1) Age in months 1 to 12 24 (33.8) 47 (66.2) 71 (34.5) 0.02 13 to 60 15 (25.9) 43 (74.1) 58 (28.2) 61 to 120 9 (20.9) 34 (79.1) 43 (20.9) 121 to 168 11(32.4) 23 (67.6) 34 (16.5) Residence Rural 32 (25.8) 92 (74.2) 124 (60.2) 0.99 Urban 27 (32.9) 55 (67.1) 82 (39.8) Weight (kg) (Mean± SD) 13.54 ±10.59 15.29±10.23 0.09 Patient category Medical patient 51 (28.5) 128 (71.5) 179 (86.9) 0.90 Surgical patient 8 (29.6) 19 (70.4) 27 (13.1) Source of admission Pediatric EOPD 24 (25.5) 70 (74.5) 94 (45.6) 0.28 Pediatric ward 24 (30.4) 55 (69.6) 79 (38.3) Surgical ward 8 (32) 17 (68) 25 (12.1) Referral 3 (37.5) 5 (62.5) 8 (3.9) Nutritional status Normal 47 (29.9) 110 (70.1) 157 (76.2) 0.91 Malnourished 12 (24.5) 37 (75.5) 49 (23.8) Vaccination status Fully vaccinated 38 (31.7) 82 (68.3) 120 (58.3) 0.18 Not vaccinated 21 (24.4) 65 (75.6) 86 (41.7) Frequency admission Frist admission 44 (28) 113 (72) 157 (76.2) 0.27 Readmission(≥2) 15 (30.6) 34 (69.4) 49 (23.8) Caregiver’s Parents 55 (29.7) 130 (70.3) 185 (89.8) 0.46 Siblings 2 (16.7) 10 (83.3) 12 (5.8) Grandparents 2 (22.2) 7 (77.8) 9 (4.4) Caregiver’s education No formal education 25 (31.3) 55 (68.7) 80 (38.8) 0.60 Primary school (1-8) 7 (19.4) 29 (80.6) 36 (17.5) Secondary school (9-12) 8 (25) 24 (75) 32 (15.5) College/University 19 (32.8) 39 (67.2) 58 (28.2) Caregiver’s occupation Farmer 26 (27.7) 68 (72.3) 94 (45.6) 0.99 Merchant/labor work 14 (29.8) 33 (70.2) 47 (22.8) Employee (Govt./private) 14 (31.8) 30 (68.2) 44 (21.4) Others 5 (23.8) 16 (76.2) 21 (10.2) Others : Unemployed, students, and Housewife. Govt .: Governmental, JMC : Jimma Medical Center, SD : Standard deviation, SPHMMC: St. Paul’s Hospital Millennium Medical College, EOPD : Emergency outpatient department. Table 2 Reason for admission among the study participant admitted to PICU at selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021. Variables Outcome n (%) Frequency (%) Died Survived Reason for admission Infectious 37 (33) 75 (67) 112 (54.4) Non-infectious 22 (23.4) 72 (76.6) 94 (45.6) Primary Diagnosis Severe Pneumonia 13 (37.1) 22 (62.9) 35 (17) Severe sepsis/septic shock 12 (37.5) 20 (62.5) 32 (15.5) Complicated meningitis 9 (36) 16 (64) 25 (12.1) Congestive heart failure 3 (13) 20 (87) 23 (11.2) Post-operative 3 (23.1) 10 (76.9) 13 (6.3) Guillen Barrie Syndrome 3 (23.1) 10 (76.9) 13 (6.3) Severe Asthma 1 (11.1) 8 (88.9) 9 (4.4) Upper airway obstruction 1 (14.3) 6 (85.7) 7 (3.4) Traumatic brain injury 2 (33.3) 4 (66.7) 6 (2.9) Acute Glomerulonephritis 1 (16.7) 5 (83.3) 6 (2.9) Disseminated Tuberculosis 2 (33.3) 4 (66.7) 6 (2.9) Cardiogenic shock 2 (40) 3 (60) 5 (2.4) Diabetic ketoacidosis 1 (20) 4 (80) 5 (2.4) Status epileptics 2 (40) 3 (60) 5 (2.4) Miscellaneous conditions* 4 (25) 12 (75) 16 (7.9) Miscellaneous conditions* : Bronchiolitis, down syndrome, hepatic failure, generalized tetanus, corpulmonale, severe malaria, and organophosphate poisoning. Table 3 Clinical characteristics of the study participant admitted to PICU at selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021. Variables Outcome n (%) Frequency (%) P - value Died Survived Organ dysfunction Yes 51 (33.1) 103 (66.9) 154 (74.8) 0.20 NO 8 (15.4) 44 (84.6) 52 (25.2) Level of consciousness GCS > 8 36 (23.4) 118 (76.6) 154 (74.8) 0.02 GCS ≤ 8 23 (44.2) 29 (55.8) 52 (25.2) Oxygen saturation (%) Less than 90% 45 (36.9) 77 (63.1) 122 (59.2) 0.02 90 to 100% 14 (16.7) 70 (83.3) 84 (40.8) Use of MV Yes 49 (34.5) 93 (65.5) 142 (68.9) 0.05 No 10 (15.6) 54 (84.4) 64 (31.1) Patient’s access to airway ETT 42 (35.3) 77 (64.7) 119 (83.8) 0.65 Tracheotomy 7 (30.4) 16 (70.6) 23 (16.2) PIM2 score >5 45 (33.3) 90 (66.7) 135 (65.5) 0.75 ≤5 14 (19.7) 57 (80.3) 71 (34.5) Length of stay on MV in days 7 7 (26.9) 19 (73.1) 26 (18.3) GCS : Glasgow coma scale, ETT: Endotracheal tube, PIM2 : pediatric index of mortality 2, MV : mechanical ventilation. Table 4 Distribution of type of treatments given during ICU stays among patients admitted to PICU of selected tertiary care hospitals in Ethiopia from October 2020, to May 2021, (N=206). Type of treatments given during ICU stays Outcome n (%) Frequency (%) Yes No Antibiotics 56 (30.3) 129 (69.7) 185 (89.8) Fluid therapy 40 (25.3) 118 (74.7) 158 (76.7) Analgesics 28 (25.7) 81 (74.3) 109 (52.9) Nutritional treatments 20 (27.8) 52 (72.2) 72 (35) Steroids 11 (16.7) 55 (83.3) 66 (32) Diuretics 15 (23.6) 42 (73.7) 57 (27.7) Sedatives 9 (16.7) 45 (83.3) 54 (26.2) Inotropes use 15 (29.4) 36 (70.6) 51 (24.8) Anticonvulsants 11(30.6) 25 (69.4) 36 (17.5) Stress-ulcer prophylaxis 10 (28.6) 25 (71.4) 35 (17) ACE-Inhibitors 2 (7.4) 25 (92.6) 27 (13.1) Anti-asthmatic 2 (10) 18 (90) 20 (9.7) Anti-malarial 4 (21.1) 15 (78.9) 19 (9.2) Miscellaneous drug class* 18 (26.9) 49 (73.1) 67 (32.5) Miscellaneous drug class*: Insulin, blood transfusion, Thrombosis prophylaxis, Antifungal, Beta-blockers, Anti- hypertensive, and Anti -helminthic. Table 5 Causes of death among patients admitted at JMC and SPHMMC, from October 1 to May 30, 2021. Causes of Death Frequency (n=59, %) Respiratory failure 19 (32.2) Septic shock 11 (18.6) Cardiac arrest 9 (15.3) Multi organ failure 7 (11.9) Complicated meningitis 6 (10.1) Brain death 5 (8.5) GBS 2 (3.4) Total 59 (100%) Table 6 Bivariate and multivariable Cox proportional hazard regression to identify predictors of in-ICU mortality at JMC and SPHMMC, from October 01, 2020, to May 30, 2021 Variables Outcome CHR (95% CI) AHR (95%CI) P-value Died Survived Sex Female 30 (26.5) 83 (73.5) 1.38 (0.82, 2.33) 1.14 (0.65, 1.99) 0.65 Male 29 (31.2) 64 (68.8) 1 1 Infectious disease Yes 37 (33) 75 (67) 0.52 (0.28, 0.94) 1.06 (0.57, 1.97) 0.86 No 22 (23.4) 71 (76.6) 1 1 Sepsis diagnosis Yes No 12 (37.5) 47 (27) 20 (62.5) 127 (73) 0.50 (0.27, 0.96) 1 2.43 (1.24, 4.78) 0.01 Organ dysfunction Yes No 51 (33.1) 8 (15.4) 103 (66.9) 44 (84.6) 0.60 (0.28, 1.26) 1 1.06 (0.29, 3.98) 1 0.94 GCS ≤8 23 (44.2) 29 (55.8) 0.51 (0.30, 0.86) 1.96 (1.12, 3.43) 0.02 >8 36 (23.4) 118 (76.6) 1 1 Oxygen Saturation ≤90% >90% 45 (36.9) 14 (16.7) 77 (63.1) 70 (83.3) 0.52 (0.28, 0.94) 1 1.29 (0.62, 2.71) 1 0.49 PIM2 score ≥5 >5 45 (33.3) 14 (19.7) 90 (66.7) 57 (80.3) 0.67 (0.37, 1.22) 1 1.27 (0.53, 3.04) 1 0.59 Antibiotics use Yes 56 (30.3) 129 (69.7) 0.49 (0.15, 1.56) 0.56 (0.17, 1.84) 0.34 No 3 (14.3) 18 (85.7) 1 1 Use of MV Yes 49 (34.5) 93 (65.5) 0.58 (0.29, 1.15) 0.45 (0.21, 0.92) 0.03 No 10 (15.6) 56 (84.4) 1 1 Sedative drugs use Yes 9 (16.7) 45 (83.3) 2.41 (1.18, 4.92) 2.40 (1.16, 4.95) 0.02 No 50 (32.9) 102 (67.1) 1 1 In-ICU Complications Yes 11 (23.9) 35 (76.1) 2.13 (1.08, 4.57) 2.13 (1.02, 4.42) 0.04 No 48 (30) 112 (70) 1 1 CHR: Crude hazard ratio, AHR: Adjusted hazard ratio, CI: Confidence interval, MV : mechanical ventilation, ICU : Intensive care unit, PIM : Pediatric index of mortality, GCS : Glasgow coma scale. 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Bacha","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIie2PMQrCQBBFdxnYNFHbFSVeQVmICIpnEUGbiG0Ki4AQG7UUrbyFtUGIjTeYSgRt10ZERUyMrUlKwX3F/Cn+YxhCFIrfhRECQchw1dII649C56EC6ZQI0N8zoZ2bbfyDtLNGdaTtD/XbqpQFQuXZ+q5w7HTL6x0TxY0uRG+KFRcI5BermDNomdxzWWsOOiv0xkgDhUEmRilh/8K9Z6hop3ttjM1EpYwW454TKsQEcsVWolLBjsl3PhMcdJGfONh2gQ5jfzGwfeT2wDd4bruX1wc2lqOhJ89x70f4UVD3PZ3EfsDgk480ZYVCofg3XuVjTAPGvlv3AAAAAElFTkSuQmCC","orcid":"","institution":"Ambo University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Amente","middleName":"Jorise","lastName":"Bacha","suffix":""},{"id":108898670,"identity":"da757bf3-8c0e-4a60-8644-ef4fb20cb8d9","order_by":1,"name":"Diriba Alemayehu Gadisa","email":"","orcid":"","institution":"Ambo University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Diriba","middleName":"Alemayehu","lastName":"Gadisa","suffix":""},{"id":108898671,"identity":"40195400-59e3-4082-8246-8385f3ba7725","order_by":2,"name":"Getandale Zeleke Negera","email":"","orcid":"","institution":"Jimma University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Getandale","middleName":"Zeleke","lastName":"Negera","suffix":""}],"badges":[],"createdAt":"2022-05-15 12:59:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1658360/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1658360/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":22098389,"identity":"13c25363-ac8e-479f-83a2-3c5031682339","added_by":"auto","created_at":"2022-05-31 21:13:16","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":36757,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flow chart (overview of the study participants)\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-1658360/v1/204f8e8135f676709d179365.png"},{"id":22098388,"identity":"2c14e5d3-6936-4116-bd54-15032afa6a16","added_by":"auto","created_at":"2022-05-31 21:13:16","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":40536,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCommonly prescribed specific medications during ICU stay among patients admitted to JMC and SPHMMC, from October 1 to May 30, 2021.\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-1658360/v1/eb888f0938bf734be40b2d10.png"},{"id":22098278,"identity":"b093e237-e99b-460d-ba9b-9e56472038ff","added_by":"auto","created_at":"2022-05-31 21:08:16","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":30614,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eOutcome at discharge among patients admitted to JMC and SPHMMC, from October 1 to May 30, 2021.\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-1658360/v1/c185e5b9b2122ff471276b2c.png"},{"id":22098281,"identity":"17d573b4-5078-4595-967e-310843587f7b","added_by":"auto","created_at":"2022-05-31 21:08:16","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":55069,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurvival estimates for patients with infectious and non-infectious related admissions at JMC and SPHMMC, from October 1 to May 30, 2021\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-1658360/v1/ed586b02f0c5617c3cc34f45.png"},{"id":24395875,"identity":"0b20bc13-71c7-4de6-a8ec-93e621ebee3a","added_by":"auto","created_at":"2022-07-27 11:29:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":930336,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1658360/v1/23379e3d-e20a-452a-9c38-2734afbeb02a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Survival Status and its predictors among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntensive care is a multi-disciplinary and inter-professional specialty committed to the management of patients with serious organ dysfunction (1). The PICU is a specifically staffed, separate, and independent area in the health care facilities dedicated to the broad manage\u003cem\u003em\u003c/em\u003eent of patients with critical illnesses to reduce mortality by strictly monitoring and treating severely ill patients who are considered to be at high risk of death (1,2).\u003c/p\u003e\n\n\u003cp\u003eRegardless of significant improvement in decreasing child mortality, worldwide childhood mortality rates remain high and children continue to face extensive regional disparities in their chances of existence(3). The WHO report shows that the major causes of pediatric death in developing countries are preventable and curable diseases if treatment is optimized (4,5). The prevalence of PICU mortality was varied in developed and developing countries, which is very high in the low-income countries (6\u0026ndash;10) as compared to high-income countries (11\u0026ndash;13). In the United States (US), the primary causes of mortality among under-five children were congenital anomalies and accidental injuries, But in unindustrialized countries, most childhood mortality were due to infections such as pneumonia, diarrhea, and severe malaria(2). \u003c/p\u003e\n\n\u003cp\u003eAdvances in pediatric intensive care have radically enhanced the prognosis for critically ill patients, but pediatric critical care services were reasonably young in developing countries and children\u0026rsquo;s mortality remains a major health problem; particularly in Sub-Saharan Africa (SSA) with varying qualities and quantities of infrastructure necessary for the provision of suitable critical care services(14). In 2020 alone, SSA remains to be the region with the highest under-five mortality rate, which accounts for 53% of all under-five deaths globally (3,15). Studies conducted in Mozambique, Rwanda and Eritrea showed that mortality rates in the ICU were found to be high which were 25%, 50% and 25.3%, respectively (9,16,17).\u003c/p\u003e\n\n\u003cp\u003eEthiopia is one of the top five countries with the world\u0026apos;s highest under-five mortality rates, which accounts for 59 deaths per 1000 live births (4,18). Based on available findings , pediatric ICU is where the utmost number of mortality happens in the most hospitals of Ethiopia and studies conducted in Ethiopia reported that the overall mortality rate of patients admitted to pediatric ICU was 8.5%, 32.6%, and 39.8% with the most common cause of death being neurologic disorders, infections, and cardiovascular disease, respectively (6,10,19).\u003c/p\u003e\n\n\u003cp\u003eDespite of the high burden of critically ill children in developing countries and while PICU is an essential area of service to save the lives of patients with acutely life-threatening conditions; organizational details of pediatric ICUs in low-income settings and available data on pediatric intensive care, specifically on the incidence of mortality, and its predictors among patients admitted to PICU in our country remain insufficient. Also, most of the existing evidence of mortality in the pediatric ICUs were limited to single-center, revised patient medical charts retrospectively (6,8,10,19,20). \u003c/p\u003e\n\n\u003cp\u003eIn Ethiopia, there are a small number of pediatric ICUs established for the pediatric patients and in addition to that; there is an inadequate resource to provide care for critically ill patients. This makes the establishment of adequate service and enhancement of outcomes difficult. So, there is a great need to conduct an extensive study on the hospitals based, particularly ICU basis to obtain reliable information on this area. Therefore, the aims of this study was to determine the incidence of mortality and its predictors among patients admitted to selected tertiary care hospitals in Ethiopia.\u003c/p\u003e"},{"header":"Methods And Participants","content":"\u003cp\u003e\u003cstrong\u003eStudy design, period, and setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn institutional-based prospective observational study was conducted among pediatrics patients admitted to the PICU at Jimma Medical Center (JMC), and St. Paul\u0026rsquo;s Hospital Millennium Medical College (SPHMMC) from October 2020 to May 2021. JMC is the teaching and referral hospital in southwest Ethiopia located in Jimma town and it provides services for over 20 million catchment population. Currently, the hospital has more than 600-bed capacities, and its PICU has four beds with electronic monitors and mechanical ventilators for patients admitted from different departments of the hospital.\u003c/p\u003e\n\n\u003cp\u003eSPHMMC is a tertiary care hospital located in Addis Ababa, the capital city of Ethiopia. It is one of the largest government hospitals in the nation and its core services included the provision of medical care, teaching, and research. The hospital gives for patients coming from Addis Ababa and all over Ethiopia. Currently, the hospital has more than 750 beds, of these; the PICU has six beds with electronic monitors and mechanical ventilators for patients admitted to PICU.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource and study population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll pediatric patients admitted to the pediatric ICU of JMC and SPHMMC were our source population, while pediatric patients admitted to the pediatric ICU during the study period that fulfilled the inclusion criteria were our study population.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eStudy Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDependent Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSurvival statuss at PICU discharge (ICU mortality) \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge, gender, residence, weight, patient category, nutritional and vaccination status, source of admission, frequency of admission, the reason for admission presence of comorbid illness, mental status, organ dysfunction, intervention during ICU stay, PIM2 score, and length of ICU stay, and caregiver\u0026rsquo;s related factors. \u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEligibility criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll pediatric patients who were admitted to the PICU of JMC and SPHMMC during the study period were included, while those who died on arrival or died within two hours of admission and patients who had inadequate data were excluded. \u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eSample Size Determination and Sampling procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size for this study was calculated using a single population proportion formula where, No = minimal sample size required, z = 1.96 (normal deviate corresponding to 95% confidence interval), w = 0.05 (degree of precision of 5%), p = 0.326 (a mortality rate of 32.6%; from study conducted in Ethiopia (10). \u003c/p\u003e\n\u003cp\u003e\u003cimg 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\"\u003e\u003c/p\u003e\n\u003cp\u003eSince the target population was less than 10,000, then the exact sample size was adjusted as; nf = No/1+No/N, nf is the corrected sample size and N is obtained from the previous admission data from two hospitals (SPMMC = 229, JMC = 186), which was 415.\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\n\u003cp\u003eThen, by adding a 10% contingency value, the final sample size was 206\u003cstrong\u003e \u003c/strong\u003epatients. Based on the previous admissions, this number was proportionally divided for both hospitals in the ratio of 1:1.24. Accordingly, 92 and 114 patients were allocated for JMC and SPHMMC, respectively. A consecutive sampling technique was used and all consecutively admitted patients to PICU from October 2020 to May 2021 were included, based on the inclusion criteria.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eData collection Tools and Procedures \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo ensure content validity, the data collection tool was adapted from previous related studies and patient charts were examined as per the objectives of the study. The data were collected by one bachelor nurse and one clinical pharmacist recruited from each department who was working at SPHMMC and JMC after taking assent from the caregivers. Training on data collection was given for data collectors before beginning the data collection. Clinical character such as SBP, pupillary light reflex; oxygen saturation, and need for mechanical ventilation (MV) were assessed within the first hour and entered into an electronic application to calculate the Pediatric Index of Mortality 2 (PIM2) Score (21).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eData Quality Assurance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore the actual data collection, the questionnaire adapted from previous studies was translated to the local official languages (Amharic and Afan Oromo), and then back to the English version to ensure the data content. A pretest was done on 5% of a sample before the actual data collection to check the consistency and validity of the structured data collection format. The collected data were double-checked by the data collector and the principal investigator for completeness, accuracy, and clarity. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData processing and Analysis \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were checked manually for completeness, and entered into Epi-data manager version 4.6 and then sent to SPSS version 23 for statistical and survival analysis. Descriptive analysis was performed to recap baseline characteristics, and results were presented by the text, tables, and figures. Kaplan-Meier curves were computed to compare the survival status of patients. Bivariate analysis was conducted and variables having a p-value \u0026lt; 0.25 were considered as candidates for multi-variable regression. Multi-variable cox proportional hazard model was performed to identify factors associated with in-ICU mortality. The hazard ratio was used as a measure of the strength of association and variables with a p-value of \u0026lt; .05 were reflected to declare statistical significance. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational definitions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePediatric Intensive Care Unit \u003c/strong\u003e\u0026ndash; is a specially staffed, separate, and self-contained area in the hospital dedicated to the detailed management of critically ill patients (1,2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIn-ICU mortality: \u003c/strong\u003eis defined as all-cause ICU mortality from index admission to discharge ascertained by death summary from healthcare records/physicians\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEvent (death):\u003c/strong\u003e is the cessation of all biological function that sustains an organism (patient who died in the hospital during on treatment). \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCensored\u003c/strong\u003e: It refers to patients who were discharged alive from the pediatric ICU.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIn-ICU complications \u003c/strong\u003eare patient who develops other conditions during their ICU stay.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLength of ICU stay: \u003c/strong\u003erefer to the duration of ICU stay in days from the date of admission to the date of discharge from pediatric ICU\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical outcome\u003c/strong\u003e: It\u0026rsquo;s the outcome of the patient until he or she leaves the hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePediatric Index of Mortality (PIM2) score\u003c/strong\u003e: is a mortality prediction tool that considers data on the type of admission (elective or emergency), diagnosis risk, mechanical ventilation, systolic blood pressure, base excess by blood PH, arterial oxygen pressure, and pupillary examination data within the first hour of ICU admission (21).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of 217 consecutive patients admitted to pediatric ICU of JMC and SPHMMC over eight months period, 206 patients were included. Of these patients enrolled, eleven patients were excluded (age \u0026lt; 1 month = 4, died \u0026lt; 2 hours of ICU admission = 5, parent\u0026rsquo;s reject assent = 2). Finally, data of 206 patients were included in the study. A majority, 114 (55.3%) of the patients were from SPHMMC. Of patients analyzed, 179 (86.9%) patients were medical and 27 (13.1%) with surgical admissions (\u003cstrong\u003eFigure1\u003c/strong\u003e) \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf patients admitted, 113 (54.9%) were female, giving a male to female ratio of 1:1.22. The mean \u0026plusmn; SD age of the patients admitted in ICU was 55.99\u0026plusmn;54.93 months. More than half, 124 (60.2%) of the patients were from a rural area, and 94 (45.6%) patients were admitted from the pediatric emergency department. Of all the patients analyzed, 38 (18.4%) were severely malnourished (\u0026lt;\u0026ndash;3 Z-score). The majority of patients were medical patients, which accounted for 179 (86.9%) and 157 (76.2%) were new admissions. Regarding the vaccination status, 120 (58.3%) was fully vaccinated. The majority, 185 (89.8%) of the caregivers were parents and 80 (38.8%) had no formal education and around 94 (45.6%) of them were farmers (\u003cstrong\u003eTable1\u003c/strong\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Characteristics of admitted Patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe most common cause for ICU admission was severe pneumonia, 35 (17%), followed by septic shock 32 (15.5%), and complicated meningitis 25 (12.1%) (\u003cstrong\u003eTable2\u003c/strong\u003e). Regarding the consciousness level of patients at arrival to the ICU, 52 (25.2%) patients were presented with severe impairment of consciousness. One hundred twenty-two (59.2%) patients had oxygen saturation \u0026lt; 90% at ICU admission. The mean \u0026plusmn;SD of PIM-2 score was 7.08\u0026plusmn; 5.93 with the majority of them, 135 (65.5%) were \u0026gt;5 scores. More than two-thirds, 142 (68.9%) of patients were mechanically ventilated. The median length of stay in the PICU was 5 (IQR: 3\u0026ndash;9) days and the majority, 104 (50.5) of patients were died within 7 days of ICU admission. Forty-eight patients (23.3%) developed complications during their ICU stay (\u003cstrong\u003eTable\u003cem\u003e \u003c/em\u003e3\u003c/strong\u003e).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eType of Treatment Given During PICU Stay\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf medication prescribed in pediatric ICU, almost all patients were treated with different types of antibiotics 185 (89.8%), followed by fluid resuscitation 158 (76.7%), analgesics, 109 (52.9%), and nutritional treatments (\u003cstrong\u003eTable 4\u003c/strong\u003e). Majority, 149 (72.3%) of the patients were treated with ceftriaxone followed by vancomycin 71 (34.5%), morphine 68 (33%), and metronidazole 63 (30.6%) (\u003cstrong\u003eFigure 2\u003c/strong\u003e).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eSurvival status of admitted patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIn-ICU mortality\u003c/strong\u003e: During the study period, 59 (28.6%) patients died, and the incidence of mortality was 3.6 deaths per 100 person-day observations One hundred forty-seven (71.4%) patients were survivors, among them the majority 76 (51.7%) were improved and transferred to the wards (\u003cstrong\u003eFigure 3\u003c/strong\u003e). The (mean \u0026plusmn;SD) survival times among patients admitted with infectious and non-infectious related diseases were 19.96 \u0026plusmn;1.84, and 27.24 \u0026plusmn; 2.52 days respectively (log-rank p= 0.08) (\u003cstrong\u003eFigure 4\u003c/strong\u003e). The commonest causes of death were respiratory failure, 19 (32.2%), followed by septic shock, 11 (18.6%), cardiac arrest, 9 (11.9%), multi organ failure 7(11.9%), and complicated meningitis, 6 (10.1%) (\u003cstrong\u003eTable 5\u003c/strong\u003e).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePredictors of in-ICU mortality \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCox regression was done to identify the association between baseline characteristics and in-ICU mortality. Accordingly, sepsis diagnosis, sex, infectious disease, organ dysfunction, need of mechanical ventilator, PIM2 score, patient use of sedative drugs, Oxygen saturation at admission, antibiotics use, GCS at admission, and complications in the ICU had a p-value of \u0026lt; 0.25. With a multivariate cox proportional hazard regression modeling, complications in the ICU (AHR: 2.13; 95%CI: [1.02, 4.42]; p = 0.04), sepsis diagnosis (AHR: 2.43; 95%CI: [1.24, 4.78]; p = 0.01), GCS\u0026lt;8 (AHR: 1.96; 95%CI: [1.12, 3.43]; p = 0.02), use of sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p= 0.02) were linked with increased risk of in-ICU mortality. The use of mechanical ventilation was associated with decreased mortality (AHR: 0.45; 95%CI: [0.21, 0.92]; p = 0.04). Then, the hazard of mortality was two times higher for patients who developed complications in pediatric ICU (AHR: 2.13; 95%CI: [1.02, 4.42]; p= 0.04) as compared with non-complicated patients. Also, the hazard of mortality was 2.40 times higher in patients who used sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p = 0.01)\u003cstrong\u003e\u003cem\u003e \u003c/em\u003e\u003c/strong\u003eas compared with non-users of sedative drugs. Mortality was 55% lower for those who use mechanical ventilators during their ICU stay than non-users of MV (AHR: 0.45; 95%CI: [0.21, 0.92]) (\u003cstrong\u003eTable 6\u003c/strong\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the survival status and its predictors among patients admitted to pediatric ICU patients treated at two selected Ethiopian tertiary care hospitals. Our study is the first report from a two-center prospective observational study in a PICU in Ethiopia that demonstrates the mortality is high and identified predictors of mortality such as complications in the ICU, use of sedative drugs, sepsis diagnosis, GCS\u0026thinsp;\u0026lt;\u0026thinsp;8 and use of mechanical ventilator.\u003c/p\u003e \u003cp\u003eIn this study, the overall in-ICU mortality was 28.6% with an incidence of 3.63 deaths per 100 person-day observations. This finding is consistent with the mortality rate in the studies conducted in Pakistan, (26.6%) (22), Egypt, (33.1%) (23), Mozambique, (25%) (7), Eritrea, (25.3%) (16) and Gonder (Ethiopia), (32.6%) (10). However, it is lower than the finding of a retrospective cross-sectional study done in Jimma (Ethiopia) from 2009 to 2013, (40%) (8).\u003c/p\u003e \u003cp\u003eThe difference could be attributed to the higher proportion of trauma patients admitted in their PICU compared with ours. Furthermore, the proportion of mortality in our PICU is higher than the finding of a study conducted in Ayder Referral Hospital (Ethiopia), Iran, Pakistan, Nepal, and India (8.5%, 16.5%, 11.9%, 12.6%, and 14%), respectively (6,11,24\u0026ndash;26).\u003c/p\u003e \u003cp\u003eThe higher proportion of deaths in our setting could be explained by the fact that this is tertiary center, which accepts referrals from distant locations resulting in delayed presentation, and most of the patients were seriously ill when admitted to our setting. This may be due the insufficient mechanical ventilator in our setting for those in need. In addition, the lack of a high dependency unit in the study area might be one of the contributing factors for the higher rate of ICU mortality.\u003c/p\u003e \u003cp\u003eA higher proportion of death was reported among patients with infectious diseases (17.9%) versus non-infectious (10.7%). This finding is in line with most of the studies conducted in developing countries, in which more than half of deaths were attributed to infectious diseases (7,9,10,27). However, several findings from developed countries reported non-infectious disease as the most common cause of death (11\u0026ndash;13). This could be because of low socio-economic, poor hygiene, and inaccessibility of health care facilities in developing settings.\u003c/p\u003e \u003cp\u003eOur study showed that respiratory failure was the leading cause of death accounting for (32.2%) of total death, followed by septic shock (18.6%), cardiac arrest (11.9%), and complicated meningitis (10.1%). This finding is comparable with the study conducted in Mozambique, Gonder (Ethiopia), Iran, Bangladesh, and India (7,10,11,27,28). In contrary to our finding, the leading cause of death was the withdrawal of life-sustaining treatments in the study done in the US, (13), trauma in a study done in Jimma (8), and renal failure in study conducted in Eretria (16). This difference might be due to differences in study design, the pattern of admission, and the ICU service provided.\u003c/p\u003e \u003cp\u003eThe mean (\u0026plusmn;\u0026thinsp;SD) length of stay in PICU was 7.87\u0026thinsp;\u0026plusmn;\u0026thinsp;7.86 days with (59.7%) of patients stayed within 2 to 7 days of ICU admission in our study. This finding is consistent with the study done in Rwanda (6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;8.5 days) (9), and Nepal (6.29 days) (29), but on contrary to a study done in Pakistan (4.11\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88 days) (22). The difference in mean length of stay might be due to variation in admission pattern, the quality of care delivered to the patients in ICU, and in-ICU complications might be one of the contributing factors for the higher length of ICU stay in our setting.\u003c/p\u003e \u003cp\u003eThis study also identified the independent predictors of in-ICU mortality. Hence, the presence of in-ICU complications, sepsis diagnosis, GCS\u0026thinsp;\u0026lt;\u0026thinsp;8, and use of sedative drugs were found to be independent predictors of mortality at the PICU, while the use of a mechanical ventilator was associated with a lower risk of mortality. Patients who developed complications during their ICU stay were two times more likely to die than those without compilations (p\u0026thinsp;=\u0026thinsp;0.04). There is no published study for comparison purposes. But, this could be since complications are associated with an increased probability of death because of a double burden on initial illnesses.\u003c/p\u003e \u003cp\u003eThis study indicated that the hazard of mortality was 2.40 times higher in patients who took sedative drugs (p\u0026thinsp;=\u0026thinsp;0.02). This is comparable with the study conducted in Rwanda (9), Greece, (11), and Harvard children\u0026rsquo;s hospital, Boston (30); the use of the sedative drug was correlated with increased risk of in-ICU mortality. This might be due to sedation leaves the patient at risk of needing prolonged respiratory support, specifically mechanical ventilator, prolonged ICU stays, and it also put critically ill patients at high risk of developing PICU-acquired complications (9,11,30).\u003c/p\u003e \u003cp\u003eChildren admitted with reduced level of consciousness (GCS\u0026thinsp;\u0026lt;\u0026thinsp;8) had nearly two times increased risk of mortality than those admitted with higher. This is consistent with the findings of studies done in Iran (11). The child who had a sepsis diagnosis had an increased hazard of mortality than those who had not. This finding was consistent with other studies conducted in Iran (31). This could be because of patients with severe sepsis have a low spare of physiologic function.\u003c/p\u003e \u003cp\u003eThe in-ICU mortality was 55% lower for those who use mechanical ventilators during their ICU stay than non-users. This finding is contrasting with a study conducted in TASH (19), and Gonder (Ethiopia) (10), in which the use of mechanical ventilator was significantly correlated with an increased risk of in-ICU mortality. The possible justification that use of MV was associated with reduced risk of death in our study might be related to the fact that severe pneumonia which could lead to Acute Respiratory Distress Syndrome (ARDS) was the commonest cause of admission and most patients with ARDS benefit from MV.\u003c/p\u003e \u003cp\u003eThough this study is a two center prospective study conducted in resource limited country, it has some limitations. First, the income of caregivers that might affect the survival status of pediatric patients was not assessed because it was difficult to ascertain since the majority of admissions were from a rural area and they usually under-report the assets they have. Secondly, PIM2 scoring was based on 8 out of 10 parameters as there was no arterial blood gas analyzer in our PICU during the study period. Finally, sample size is small and it may affect power of the study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study found high incidence of in-ICU mortality among pediatrics patients in selected Ethiopian tertiary care hospitals. Respiratory failure, septic shock and cardiac arrest were the common causes of admission and death. In-ICU complications, sepsis diagnosis, GCS\u0026thinsp;\u0026lt;\u0026thinsp;8, and use of sedative drugs were linked with increased risk of in-ICU mortality in contrast to the use of mechanical ventilator. Therefore, prudent follow up is warranted for those patients with aforementioned risk factors.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eAHR\u003c/strong\u003e: Adjusted Hazard Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eARDS\u003c/strong\u003e: Acute Respiratory Distress Syndrome\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCHR\u003c/strong\u003e: Crude Hazard Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e: Confidence Interval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEOPD\u003c/strong\u003e: Emergency Outpatient Department\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eETT\u003c/strong\u003e: Endotracheal Tube\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGBS\u003c/strong\u003e: Gillian Barre Syndrome\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGCS\u003c/strong\u003e: Glasgow Coma Scale\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eICU\u003c/strong\u003e: \u0026nbsp;Intensive Care Unit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIQR\u003c/strong\u003e: Inter Quarter Range\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJMC\u003c/strong\u003e: Jimma Medical Center\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLOS\u003c/strong\u003e: Length of Stay\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMV\u003c/strong\u003e: Mechanical Ventilation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePICU\u003c/strong\u003e: Pediatric Intensive Care Unit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePIM2\u003c/strong\u003e: Pediatric Index of Mortality 2\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e: Standard Deviation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSPHMMC\u003c/strong\u003e: Saint Paul\u0026rsquo;s Hospital Millennium Medical College\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSPSS:\u003c/strong\u003e\u0026nbsp; Statistical Package of Social Science\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSSA:\u003c/strong\u003e Sub-Saharan Africa\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTASH\u003c/strong\u003e: Tikur Anbesssa Specialized Hospital\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUS\u003c/strong\u003e: United States\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWHO\u003c/strong\u003e: World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was done in accordance with the declaration of Helsinki. An ethical clearance letter was obtained from the institutional review board of Jimma University (\u003cem\u003ereference No:\u003c/em\u003e IRB000234/2012) and St. Paul\u0026rsquo;s Hospital Millennium Medical College (reference No: PM23/200). Then, a letter of cooperation was taken from each pediatrics and child health department of the hospital.\u0026nbsp;Informed verbal consent was gotten from the caretakers. The name of patient was not recorded on the data collection form, and all information taken from the chart was kept strictly confidential and the data retrieved was used only for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFull data for this research is available through the corresponding author up on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the design of the study and the interpretation of data. AJB: also performed the data collection, statistical analysis and drafted the manuscript.\u0026nbsp;All others authors critically revised the manuscript.\u0026nbsp;All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Jimma University for facilitating conducive environment for the research. We also would like to express our deepest heartfelt thanks to Jimma Medical Center and St. Paul\u0026rsquo;s Hospital Millennium Medical College for providing available information. Finally, our special thanks go to the study participants, data collectors and supervisors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMarshall J et. al. What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2017;37:270\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eKliegman. et al. Nelson Textbook of Pediatrics. 21 edition. Elsevier; 2017. 1\u0026ndash;36 p. \u003c/li\u003e\n\u003cli\u003eUN Inter-agency Group for Child Mortality. Levels \u0026amp; Trends in childhood mortality. In: WHO Report 2020. 2020. p. 1\u0026ndash;56. \u003c/li\u003e\n\u003cli\u003eRiviello ED, Letchford S, Achieng L and NM. Critical care in resource poor settings: lessons learned and future directions. Crit Care Med. 2011;39(4):860\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eVincent JL, Marshall JC, \u0026Ntilde;amendys-Silva SA, Fran\u0026ccedil;ois B, Martin-Loeches I, Lipman J, et al. Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations audit. Lancet Respir Med. 2014;2(5):380\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eH. Haftu, T. Hailu, A. Medhaniye TG. Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia. BMC Res Notes. 2018;11:339. \u003c/li\u003e\n\u003cli\u003ePunchak, M., Hall, K., Seni, A., Chris Buck, W., DeUgarte, D. A., Hartford, E., \u0026hellip; Muando VI. Epidemiology of Disease and Mortality from a PICU in Mozambique. Pediatr Crit Care Med. 2018;19(11):E603\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eAbebe, T., Girmay, M., G/Michael, G., \u0026amp; Tesfaye M. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital. Int J Gen Med. 2015;8(63):63\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eNyirasafari R, Corden MH, Karambizi AC, Kabayiza JC, Makuza JD, Wong R, et al. Predictors of mortality in a paediatric intensive care unit in Kigali, Rwanda. Paediatr Int Child Health. 2017;37(2):109\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eTeshager NW, Amare AT, Tamirat KS. Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: A prospective observational cohort study. BMJ Open. 2020;10(10):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eValavi, E., Aminzadeh, M., Shirvani, E., Jaafari, L., \u0026amp; Madhooshi S. The main Causes of mortality in pediatric intensive care unit in South west of Iran. Zahedan J Res Med Sci. 2018;20(4):1\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eVolakli E, Sdougka M, Tamiolaki M, Tsonidis C, Reizoglou M, Giala M. Demographic profile and outcome analysis of pediatric intensive care patients. Hippokratia. 2011;15(4):316\u0026ndash;22. \u003c/li\u003e\n\u003cli\u003eJeffrey P. Burns, Deborah E. Sellers, Elaine C. Meyer, Mithya Lewis-Newby and RDT. Epidemiology of Death in the Pediatric Intensive Care Unit at Five U.S. Teaching Hospitals. Crit Care Med. 2014;42(9):1\u0026ndash;17. \u003c/li\u003e\n\u003cli\u003eAdedokun ST YS. Childhood morbidity and its determinants: Evidence from 31 countries in sub-Saharan Africa. BMJ Glob Heal. 2020;5(e003109):1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eWHO. Newborns: improving survival and well-being. Vol. 1990, World Health Organisation. 2020. p. 9\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eMohammed M, Tekle S. Patterns And Treatment Outcomes of Pediatric Intensive Care Unit Admissions In 2013 , Orotta National Referral Hospital. Int J Pharm H Care Res. 2020;8(4):27\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eOng\u0026oacute;ndi M, Mwachiro M, Ranketi S. Predictors of mortality in a critical care unit in south western Kenya. Ann Afr Surg. 2016;13(1):3\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eEthiopian Public Health Institute (EPHI) [Ethiopia] and ICF. Ethiopia Mini Demographic and Health Survey. In: Rockville, Maryland, USA: EPHI and ICF. 2019. p. 47\u0026ndash;53. \u003c/li\u003e\n\u003cli\u003eAsmamaw Abebe, Yafet Noah He. Disease Pattern, Outcome And Associated Factor of Patient Admitted In Pediatric Intensive Care Unit At Tikur Anbessa Specialized Teaching Hospital. 2019 (unpublished article); \u003c/li\u003e\n\u003cli\u003eAshenafi T, Tilahun BC, Heye TB. Admission pattern and outcome in a pediatric intensive care unit of gondar university hospital. Ethiop Med J. 2019;57(2):111\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eVivek V. Shukla SMN, Ajay G. Phatak and JDG. Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India. Int J Pediatr. 2014;8(27):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eQamar uz Zaman Khan, Faisal Basheer, Zameer Ahmad Nayyar AIB. Clinical profiles and outcomes in pediatric intensive care unit of a tertiary care hospital in Pakistan. Pak Armed Forces Med J. 2020;70(6):1657\u0026ndash;61. \u003c/li\u003e\n\u003cli\u003eRady HI. Profile of patients admitted to pediatric intensive care unit , Cairo University Hospital. Ain-Shams J Anesthesiol. 2014;5(6):500\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eHaque, A., Siddiqui, N. R., Jafri, S. K., Hoda, M., Bano, S., Mian A. Clinical profiles and outcomes of children admitted to the pediatric intensive care unit from the emergency department. J Coll Physicians Surg Pakistan,. 2015;25(4):301\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eShah GS, Shah BK, Thapa A, Shah L, Mishra OP. Admission Patterns and Outcome in a Pediatric Intensive Care Unit in Nepal. Br J Med Med Res. 2014;4(30):4939\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eMaheswari K. et.al. Clinical Profile and Outcome of Patients Admitted to Pediatric Intensive Care Unit of a Tertiary Care Teaching Hospital in Eastern India. J Med Sci Clin Res. 2018;6(9):1289\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eHoque, M., Alam, S., \u0026amp; Ahmed A. Admission pattern and outcome in a paediatric intensive care unit of a tertiary care paediatric hospital in Bangladesh \u0026ndash; A two-year retanalysis. JJournal Bangladesh Coll Physicians Surg. 2014;4(2):134\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eMukhija DG, Chandra DS, Prasad DP. Clinical profile of patients admitted to the PICU of a tertiary care teaching hospital. Int J Pediatr Res. 2017;4(2):125\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eShrestha AK, Bhattarai S, Paudel P, Basel PL. Morbidity and mortality pattern of patients admitted into paediatric intensive care unit of tertiary level hospital of Nepal. J Nepal Paediatr Soc. 2020;40(1):28\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eEgbuta C MK. Current State of Analgesia and Sedation in the Pediatric Intensive Care Unit. 2021;10(9):18\u0026ndash;47. \u003c/li\u003e\n\u003cli\u003eAljabari S, Balch A, Larsen GY et al. Severe sepsis-associated morbidity and mortality among critically ill children with cancer. 2019;8:122\u0026ndash;9. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"text-align: center;\"\u003eTable\u0026nbsp;1\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003eSocio-demographic characteristics among patients admitted to PICU of selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021, (N=206).\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" width=\"42.68104776579353%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocio demographic variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"32.357473035439135%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome n (%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"51.42857142857143%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDied\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"48.57142857142857%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvived\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy site\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eJMC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e27 (29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e65 (70.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e92 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSPHMMC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e32 (28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e82 (71.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e114 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e30 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e83(73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e113 (54.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e29 (31.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e64 (68.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e93 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003e1 to 12 \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e24 (33.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e47 (66.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e71 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003e13 to 60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e15 (25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e43 (74.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e58 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003e61 to 120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e9 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e34 (79.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e43 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003e121 to 168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e11(32.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e23 (67.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e34 (16.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e32 (25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e92 (74.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e124 (60.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e27 (32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e55 (67.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e82 (39.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight (kg)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003e(Mean\u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e13.54 \u0026plusmn;10.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e15.29\u0026plusmn;10.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eMedical patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e51 (28.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e128 (71.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e179 (86.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSurgical patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e8 (29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e19 (70.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e27 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003ePediatric \u0026nbsp;EOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e24 (25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e70 (74.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e94 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003ePediatric ward\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e24 (30.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e55 (69.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e79 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSurgical ward\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e8 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e17 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e25 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eReferral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e3 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e5 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e8 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNutritional status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e47 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e110 (70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e157 (76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eMalnourished\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e12 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e37 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e49 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eFully vaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e38 (31.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e82 (68.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e120 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eNot vaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e21 (24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e65 (75.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e86 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency \u0026nbsp; admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eFrist admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e44 (28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e113 (72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e157 (76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eReadmission(\u0026ge;2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e15 (30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e34 (69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e49 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregiver\u0026rsquo;s\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e55 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e130 (70.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e185 (89.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSiblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e2 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e10 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e12 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eGrandparents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e2 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e7 (77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e9 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregiver\u0026rsquo;s education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e25 (31.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e55 (68.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e80 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003ePrimary school (1-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e7 (19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e29 (80.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e36 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSecondary school (9-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e8 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e24 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e32 (15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eCollege/University \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e19 (32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e39 (67.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e58 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"14.946070878274268%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregiver\u0026rsquo;s occupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"27.73497688751926%\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.640986132511557%\"\u003e\n \u003cp\u003e26 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.716486902927581%\"\u003e\n \u003cp\u003e68 (72.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.791987673343606%\"\u003e\n \u003cp\u003e94 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" width=\"10.169491525423728%\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eMerchant/labor work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e14 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e33 (70.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e47 (22.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eEmployee (Govt./private)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e14 (31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e30 (68.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e44 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.03703703703704%\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.22222222222222%\"\u003e\n \u003cp\u003e5 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.987654320987655%\"\u003e\n \u003cp\u003e16 (76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.753086419753085%\"\u003e\n \u003cp\u003e21 (10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eOthers\u003c/strong\u003e: \u003cem\u003eUnemployed, students, and Housewife. \u003cstrong\u003eGovt\u003c/strong\u003e.: Governmental, \u003cstrong\u003eJMC\u003c/strong\u003e: Jimma Medical Center, \u003cstrong\u003eSD\u003c/strong\u003e: Standard deviation, \u003cstrong\u003eSPHMMC:\u003c/strong\u003e St. Paul\u0026rsquo;s Hospital Millennium Medical College, \u003cstrong\u003eEOPD\u003c/strong\u003e: Emergency outpatient department.\u003c/em\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003eTable 2\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u0026nbsp;Reason for admission among the study participant admitted to PICU at selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021.\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" width=\"49.603803486529316%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"34.23137876386688%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.164817749603802%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"47.22222222222222%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDied\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"52.77777777777778%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvived\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"17.27416798732171%\"\u003e\n \u003cp\u003eReason for admission \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.329635499207605%\"\u003e\n \u003cp\u003eInfectious\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.164817749603802%\"\u003e\n \u003cp\u003e37 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.066561014263076%\"\u003e\n \u003cp\u003e75 (67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.164817749603802%\"\u003e\n \u003cp\u003e112 (54.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eNon-infectious\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e22 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e72 (76.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e94 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"15\" valign=\"top\" width=\"17.27416798732171%\"\u003e\n \u003cp\u003ePrimary Diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"32.329635499207605%\"\u003e\n \u003cp\u003eSevere Pneumonia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.164817749603802%\"\u003e\n \u003cp\u003e13 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.066561014263076%\"\u003e\n \u003cp\u003e22 (62.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.164817749603802%\"\u003e\n \u003cp\u003e35 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eSevere sepsis/septic shock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e12 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e20 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e32 (15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eComplicated meningitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e9 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e16 (64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e25 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eCongestive heart failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e3 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e20 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e23 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003ePost-operative\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e3 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e10 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e13 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eGuillen Barrie Syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e3 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e10 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e13 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eSevere Asthma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e1 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e8 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e9 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eUpper airway obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e1 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e6 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e7 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eTraumatic brain injury\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e2 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e4 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e6 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eAcute Glomerulonephritis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e1 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e5 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e6 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eDisseminated Tuberculosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e2 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e4 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e6 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eCardiogenic shock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e3 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e5 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eDiabetic ketoacidosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e1 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e4 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e5 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eStatus epileptics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e2 (40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e3 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e5 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"39.08045977011494%\"\u003e\n \u003cp\u003eMiscellaneous conditions*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e4 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.839080459770116%\"\u003e\n \u003cp\u003e12 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.54022988505747%\"\u003e\n \u003cp\u003e16 (7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMiscellaneous conditions*\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e: Bronchiolitis, down syndrome, hepatic failure, generalized tetanus, corpulmonale, severe malaria, and organophosphate poisoning.\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003eTable 3\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u0026nbsp;Clinical characteristics of the study participant admitted to PICU at selected tertiary care hospitals in Ethiopia from October 01, 2020, to May 30, 2021.\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" width=\"49.13657770800628%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"26.373626373626372%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e-\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDied\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvived\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003eOrgan dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e51 (33.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e103 (66.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e154 (74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e8 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e44 (84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e52 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003e\u0026nbsp;Level of consciousness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003eGCS \u0026gt; 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e36 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e118 (76.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e154 (74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003eGCS \u0026le; 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e23 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e29 (55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e52 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003eOxygen saturation (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003eLess than 90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e45 (36.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e77 (63.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e122 (59.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003e90 to 100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e14 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e70 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e84 (40.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003eUse of MV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e49 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e93 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e142 (68.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e10 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e54 (84.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e64 (31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003ePatient\u0026rsquo;s access to airway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003eETT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e42 (35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e77 (64.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e119 (83.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003eTracheotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e7 (30.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e16 (70.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e23 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003ePIM2 score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003e\u0026gt;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e45 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e90 (66.7)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e135 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003e\u0026le;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e14 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e57 (80.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e71 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"24.646781789638933%\"\u003e\n \u003cp\u003eLength of stay on MV in days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"24.489795918367346%\"\u003e\n \u003cp\u003e\u0026lt; 2\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e22(39.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.186813186813186%\"\u003e\n \u003cp\u003e34 (60.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.1287284144427%\"\u003e\n \u003cp\u003e56 (39.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" width=\"10.361067503924646%\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003e2 to 7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e20 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e40 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e60 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"37.68115942028985%\"\u003e\n \u003cp\u003e\u0026gt;7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e7 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.28985507246377%\"\u003e\n \u003cp\u003e19 (73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.73913043478261%\"\u003e\n \u003cp\u003e26 (18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eGCS\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e: Glasgow coma scale, \u003cstrong\u003eETT:\u003c/strong\u003e Endotracheal tube, \u003cstrong\u003ePIM2\u003c/strong\u003e: pediatric index of mortality 2, \u003cstrong\u003eMV\u003c/strong\u003e: mechanical ventilation.\u003c/em\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eTable 4\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u0026nbsp;Distribution of type of treatments given during ICU stays among patients admitted to PICU of selected tertiary care hospitals in Ethiopia from October 2020, to May 2021, (N=206).\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of treatments given during ICU stays\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"38.985736925515056%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"51.21951219512195%\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"48.78048780487805%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eAntibiotics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e56 (30.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e129 (69.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e185 (89.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eFluid therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e40 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e118 (74.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e158 (76.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eAnalgesics \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e28 (25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e81 (74.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e109 (52.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eNutritional treatments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e20 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e52 (72.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e72 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eSteroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e11 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e55 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e66 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eDiuretics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e15 (23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e42 (73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e57 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eSedatives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e9 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e45 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e54 (26.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eInotropes use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e15 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e36 (70.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e51 (24.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eAnticonvulsants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e11(30.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e25 (69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e36 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eStress-ulcer prophylaxis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e10 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e25 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e35 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eACE-Inhibitors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e2 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e25 (92.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e27 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eAnti-asthmatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e18 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e20 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eAnti-malarial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e\u0026nbsp;4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e19 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"40.09508716323296%\"\u003e\n \u003cp\u003eMiscellaneous drug class*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.968304278922346%\"\u003e\n \u003cp\u003e18 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"19.01743264659271%\"\u003e\n \u003cp\u003e49 (73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.91917591125198%\"\u003e\n \u003cp\u003e67 (32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMiscellaneous drug class*:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;Insulin, blood transfusion, Thrombosis prophylaxis, Antifungal, Beta-blockers, Anti-\u003c/em\u003e\u003cem\u003ehypertensive, and Anti\u003c/em\u003e\u003cem\u003e-helminthic.\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003e\u0026nbsp;Causes of death among patients admitted at JMC and SPHMMC, from October 1 to May 30, 2021.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse: collapse; margin: 0px auto;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eCauses of Death\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eFrequency (n=59, %)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eRespiratory failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e19 (32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eSeptic shock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e11 (18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eCardiac arrest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e9 (15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eMulti organ failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e7 (11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eComplicated meningitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e6 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eBrain death\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e5 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eGBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e2 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"50%\"\u003e\n \u003cp\u003e59 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003eTable 6\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cstrong\u003eBivariate and multivariable Cox proportional hazard regression to identify predictors of in-ICU mortality at JMC and SPHMMC, from October 01, 2020, to May 30, 2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" width=\"26.894502228826152%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" width=\"25.85438335809807%\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCHR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAHR (95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"18.29268292682927%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDied\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.073170731707318%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvived\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"25.609756097560975%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"25.609756097560975%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.414634146341463%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e30 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e83 (73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.38 (0.82, 2.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.14 (0.65, 1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e29 (31.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e64 (68.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eInfectious disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e37 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e75 (67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.52 (0.28, 0.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.06 (0.57, 1.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e22 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e71 (76.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eSepsis diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e12 (37.5)\u003c/p\u003e\n \u003cp\u003e47 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e20 (62.5)\u003c/p\u003e\n \u003cp\u003e127 (73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.50 (0.27, 0.96)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.43\u003c/strong\u003e (1.24, 4.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eOrgan dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e51 (33.1)\u003c/p\u003e\n \u003cp\u003e8 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e103 (66.9)\u003c/p\u003e\n \u003cp\u003e44 (84.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u0026nbsp;0.60 (0.28, 1.26)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.06 (0.29, 3.98)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eGCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003e\u0026le;8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e23 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e29 (55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.51 (0.30, 0.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.96\u003c/strong\u003e (1.12, 3.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003e\u0026gt;8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e36 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e118 (76.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eOxygen Saturation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003e\u0026le;90%\u003c/p\u003e\n \u003cp\u003e\u0026gt;90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e45 (36.9)\u003c/p\u003e\n \u003cp\u003e14 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e77 (63.1)\u003c/p\u003e\n \u003cp\u003e70 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.52 (0.28, 0.94)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.29 (0.62, 2.71)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003ePIM2 score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003e\u0026ge;5\u003c/p\u003e\n \u003cp\u003e\u0026gt;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e45 (33.3)\u003c/p\u003e\n \u003cp\u003e14 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e90 (66.7)\u003c/p\u003e\n \u003cp\u003e57 (80.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.67 (0.37, 1.22)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e1.27 (0.53, 3.04)\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eAntibiotics use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e56 (30.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e129 (69.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.49 (0.15, 1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.56 (0.17, 1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"14.457831325301205%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.072289156626507%\"\u003e\n \u003cp\u003e3 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.867469879518072%\"\u003e\n \u003cp\u003e18 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"25.301204819277107%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"25.301204819277107%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eUse of MV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e49 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e93 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e0.58 (0.29, 1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.45\u003c/strong\u003e (0.21, 0.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e10 (15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e56 (84.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eSedative drugs use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e9 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e45 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e2.41 (1.18, 4.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.40\u003c/strong\u003e (1.16, 4.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e50 (32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e102 (67.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" width=\"16.196136701337295%\"\u003e\n \u003cp\u003eIn-ICU\u003c/p\u003e\n \u003cp\u003eComplications \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.698365527488855%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"13.37295690936107%\"\u003e\n \u003cp\u003e11 (23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"12.481426448736999%\"\u003e\n \u003cp\u003e35 (76.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e2.13 (1.08, 4.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"18.7221396731055%\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.13\u003c/strong\u003e (1.02, 4.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.806835066864785%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.04\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"12.76595744680851%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.957446808510639%\"\u003e\n \u003cp\u003e48 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"14.893617021276595%\"\u003e\n \u003cp\u003e112 (70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"22.340425531914892%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.702127659574469%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCHR:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eCrude hazard ratio,\u003cstrong\u003e\u0026nbsp;AHR:\u0026nbsp;\u003c/strong\u003eAdjusted hazard ratio,\u003cstrong\u003e\u0026nbsp;CI:\u0026nbsp;\u003c/strong\u003eConfidence interval, \u003cstrong\u003eMV\u003c/strong\u003e: mechanical ventilation, \u003cstrong\u003eICU\u003c/strong\u003e: Intensive care unit, \u003cstrong\u003ePIM\u003c/strong\u003e: Pediatric index of mortality,\u003cstrong\u003e\u0026nbsp;GCS\u003c/strong\u003e: Glasgow coma scale.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Survival status, Predictors of mortality, Pediatric Intensive Care Unit, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-1658360/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1658360/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eAdvances in pediatric intensive care have radically improved the prognosis for critically sick patients.\u003cstrong\u003e \u003c/strong\u003eDespite high burden of critically ill patients in low-income countries, there is scarce evidence on the incidence of mortality and its predictors among patients admitted to Intensive care unit (ICU) in Ethiopia. Therefore, we designed this study to determine the survival status and predictors of mortality among patients admitted to pediatric ICU at selected tertiary care hospitals in Ethiopia.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA prospective observational study involving 206 admitted patients from October 2020 to May 30, 2021 was conducted in selected tertiary care hospital in Ethiopia. Data were collected on socio-demographic, clinical characteristics, treatment-related variables and entered into Epi-data version 4.6, and then exported to SPSS version 23.0 for analysis. Kaplan-Meier was used to compare the survival experience of the patients and Cox regression was used to identify independent predictors of in-ICU mortality. The hazard ratio was used as a measure of the strength of association and a p-value of \u0026lt; 0.05 was considered to declare statistical significance.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Fifty-nine (28.6%) patients were died during follow-up time, and the incidence of mortality was 3.6 deaths per 100 person-day observation. The mean ± SD survival times among patients with infectious and non-infectious related illnesses were 19.96 ± 1.84 and 27.24 ± 2.52 days respectively (log rank p = 0.08). Respiratory failure 19 (32.2%) was the commonest cause of death. In-ICU complications (AHR: 2.13; 95%CI: [1.02, 4.42]; p = 0.04), sepsis diagnosis (AHR: 2.43; 95%CI: [1.24, 4.78]; p = 0.01), GCS\u0026lt;8 (AHR: 1.96; 95%CI: [1.12, 3.43]; p = 0.02), use of sedative drugs (AHR: 2.40; 95%CI: [1.16, 4.95]; p = 0.02) 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 = 0.03).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe study found high incidence of in-ICU mortality among admitted pediatrics patients in selected Ethiopian tertiary care hospitals. In-ICU complications, sepsis diagnosis, GCS\u0026lt;8, and patient use of sedative drugs were independent predictors of in-ICU mortality. Prudent follow up is warranted for those patients with aforementioned risk factors.\u003c/p\u003e","manuscriptTitle":"Survival Status and its predictors among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-05-31 21:08:14","doi":"10.21203/rs.3.rs-1658360/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"38e055a4-5a95-478a-809e-d4c3be7beaba","owner":[],"postedDate":"May 31st, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2022-07-27T11:29:21+00:00","versionOfRecord":[],"versionCreatedAt":"2022-05-31 21:08:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1658360","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1658360","identity":"rs-1658360","version":["v1"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}