Assessment Of Admission Pattern And Outcome Of Pediatric Intensive Care Unit At Jimma University Medical Center, South West Ethiopia

Abstract

Background: In developing countries there is high burden of pediatric critical illness that requires pediatric intensive care unit admission and there is significant number of death due to variety of factors including lack of financial resources, lack of available technology and well-trained staff. Knowledge of the characteristics and outcomes of critically ill children admitted to pediatric intensive care unit may help to improve the care, prioritize the patient for better utilization of resource and decrease mortalities of critically ill pediatric patients, however, published data on the practice of critical care and patient outcomes in these settings are scant. Objective: To assess the pattern of admission, outcome and associated factors of patients who admitted to Pediatric intensive care unit, Jimma University Medical Center Method: Institutional based prospective longitudinal study was conducted. Consecutive sampling technique was used to include a total sample of 71 study participant’s. Data was collected using structured questionnaire and data extraction check list. The data obtained was cleaned and entered into a computer software EpiData version 3.0 and SPSS version 26.0 for data entry and analysis respectively. Descriptive statistics was carried out to see the patterns of admission whereas bivariate and multivariate logistic regression analysis were performed to identify the factors associated with treatment outcome. During bivariate analysis p-value of less than 0.25 at a confidence interval of 95% was considered a candidate for multivariate logistic regression. A pvalue of less than 0.05 at a confidence interval of 95% was considered as significant. Cross tabulation was used to assess exposure and non-exposure effect on dependent variable. Crude odd ratio (COR) and adjusted odd ratio (AOR) were used to explain strength of association between independent and dependent variable. Results: A total of 71 study participants were included of whom 52.1% were female with female to male ratio of 1.1:1. The age between 25 and 60 months old holds the majority (40.8 %) of the admissions with mean age of 51±44months old. The major admission diagnosis identified were Upper air way obstruction 11.3% and severe sepsis 11.3%, followed by septic shock 9.9%, complicated meningitis 9.9% and post-operative patients 9.9%. The proportion of death was 31%. In multi-variable logistic regression analysis having admission diagnosis of severe sepsis (AOR=8.97, 95% CI 1.34-59.96, P=0.024), severe acute malnutrition (AOR=15.22, 95% CI 2.76- iv 83.99, P=0.002) and being a candidate for mechanical ventilator (AOR=9.82, 95% CI 1.97-48.76, P=0.005 were found to have a significant association with patient outcome which is death. Conclusions and Recommendation: Having admission diagnosis of severe sepsis, severe acute malnutrition, being a candidate for mechanical ventilator and were factors associated with mortalities. Prevention, early identification and proper treatment of sepsis, severe acute malnutrition and related complications are strongly recommended