Abstract:
Background: Mechanical ventilation was the most common ICU intervention (80%), followed
by advanced therapies for patients with respiratory failure. Despite its utility, mechanical
ventilation had a negative impact on patients, with more than four times the risk of death. There
are limited data from developing countries including, Ethiopia regarding time to death of
mechanical ventilator patient as well its predictors.
Objective: To assess time to death and its predictors among adult patients on mechanical
ventilation admitted to ICU, west Amhara, comprehensive specialized hospitals, Amhara,
Ethiopia, 2022
Method: Institutional based retrospective follow-up study was conducted from January 1, 2020,
to December 31, 2022. Simple random sampling was used to select hospitals and a total of 391
study medical charts were reviewed by using data extraction checklist. Data was entered into
Epi-data version 4.6.0 and analyzed through Stata version 14. Results were explored using
descriptive statistics. Kaplan-Meier survival curve together with log-rank test also checked.
Proportional hazard assumption was checked both graphically and statistically. Variables having
a p-value < 0.25 in the bivariable analysis were candidates for the multivariable analysis.
Adjusted hazard ratio with 95 % confidence intervals was computed and variables with a p value < 0.05 were considered as statistically significant predictors.
Result: Median time to death was 16 days (95 CI: 11 – 22) with the overall death rate of 5.93 per
100 person-days observation (95% CI: 5.23 - 6.72). Participants who had tracheostomy
procedure (AHR: 0.40, 95% CI: (0.20- 0.80)), cardio pulmonary resuscitation (AHR: 8.78, 95%
CI: (5.38- 14.35)), low systolic blood pressure (AHR: 2.96, 95% CI: (1.11- 7.87 and bradypnea
(AHR: 2.74, 95% CI: (1.48- 5.07)). were statically significant predictors of mortality among
mechanically ventilated patients.
Conclusion and recommendation: patients treated with mechanical ventilation had lower
duration of time to death. Patients with cardio pulmonary resuscitation, low systolic blood
pressure and bradypnea had risk effect whereas patients with tracheostomy had protective effect
for time to death. So health care workers should practice tracheostomy for longer mechanical
ventilator user & give special attention for resuscitated, low systolic blood pressure & bradypnic
patients
