ASSESSMENT OF ADMISSION PATTERN, TREATMENT OUTCOME AND ASSOCIATED FACTORS OF CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT OF HIWOT FANNA COMPRHENSIVE SPECIALIZED HOSPITAL, HARAR, ETHIOPIA FROM 2021-2023

Abstract

A paediatric intensive care unit is a specialized unit that provides medical care to critically ill children. Awareness of the admission pattern and outcomes of critically ill children admitted to Paediatric Intensive Care Unit in developing countries aids with the identification of priorities and the resources needed to improve the outcome of critically ill patients. There is Lack of data on paediatrics critical care in Hiwot fanna comprehensive specialized hospital, Harar Eastern Ethiopia. Objective: To determine the admission pattern, treatment outcome and associated factors of children admitted to the paediatric intensive care unit of Hiwot Fanna compressive Specialized Hospital, Harar, Ethiopia from March 10, 2021-March 10, 2023. Data collection period was from January 10 st – January 31 th, 2024. Methodology: Institutional based retrospective cross-sectional study was performed on a sample of 398 children aged from 1month to 14 years admitted at paediatric intensive care unit of Hiwot Fanna compressive Specialized Hospital from March 10, 2021 to March 10, 2023.Clients was selected by using Simple random sampling technique and data was collected using pre-tested and structured data abstraction checklist. Data was cleaned and coded then entered excel sheet which was exported to Statistical Package of Social Science 27 for analysis. Descriptive statistics such as mean, percentage, frequency and other measure was used to describe the independent variables. A bivariate logistic regression analysis was used to identify the association between dependent and independent variable. Explanatory variables with p value less than 0.25 was entered into the multivariable logistic regression analysis model. Every variable with P-values less than 0.05 in the multivariable logistic model was considered as statistically significant. Result: A total of 398 of the patient charts were available for review; out of the 398 patients, 239 (60.1%) were male. The median age at admission was six years (range 30 days -14 years). Meningitis 126 (31.65%) is the commonest cause for admission. The overall proportion of deaths among this series of patients was 29.4 %. In Multivariable logistic analysis, GCS (3-8) at admission (AOR = 3.019; 95% C.I: 1.561 – 5.838) p= 0.001), need for inotropes (AOR = 4.424; 95% C.I: 1.623 – 12.058) p= 0.004) and length of PICU stay from 2 to 7 days (AOR = 0.093; 95% C.I: 0.03 – 0.288) P =0.001) were independent predictors of mortality. Conclusion More than a third of the children died. The highest number of admissions into the PICU was due to meningitis followed by severe pneumonia. Increased risk of mortality is associated with those who have GCS 3-8, length of stay at PICU less than or equal 1 day and needs inotropes after admission. This emphasizes the significance of educating the public about preventative techniques like vaccination, creating awareness about hygiene, and expanding ICU for early detection and treatment of critically ill children