During the 24-month study period, 317 children were admitted to the 4 beds, which is different from studies done in tertiary level PICUs in other countries. Most of the patients were female (50.5%), a finding different to that of Ayder Referral Hospital (14). In this study, the median age of patients was 3.5 years, which was an extreme outlier. The study conducted in Greek showed that the median age was higher in our study, which 4.5. As well as India (5.2 (15, 16) which was higher in this study. The discrepancy might be due to differences in technology usage and health facility equipment. For instance, in Ethiopia, it has limited medical resources, limited modern technology, and poor health facility infrastructure. In this study, the maximum number of patients belonged to the age group of > 1 year (30.6%), followed by the age group of 5 to 11 years (26.2%). This result is less likely to be similar to a study conducted in Nepal. The maximum number of patients belonged to the age group of 1 month–1 year (31.3%), followed by the age group of 1–5 years (21.7%) . In this study, the median length of stay was 20.5 days. This is inconsistent with the study conducted in East India, it was 3.72.5 days (range, 0–28 day (17). The difference may be due to differences in the study period, admission protocol, medical resources, and patient flow. For instance, in Ethiopia, the highest patient flow observed with limited medical resources (20).
This study revealed that respiratory diseases (22.9%), neurological diseases (19.6%), and cardiac disease (17.7%) were the major causes of admission to TASH PICU, as a study done in East India shows. The three most common diseases categories admitted were infectious diseases (20.7%), followed by respiratory diseases (19.1%) and central nervous system diseases (14.3%) (18). In a study conducted in Pakistan, the major diagnostic categories of medical patients were neurological (10%), respiratory (10%), and cardiac(8%)(1 And, a study conducted in Nepal shows that respiratory illness (33%), central nervous system disease (18.6%) and infectious diseases (11.3%) were the common diseases requiring PICU admission (17).
In this study, 180 (56%) patients were candidates for mechanical ventilation, and 93 (29.5%) of them died. Another study in Nepal reveals 17.8% received mechanical ventilation, of which 23 (56%) survived, 14 (34.1%) died, and 4 (9.75%) left against medical advice. Of the non-ventilated children, (81.4%) improved, (7.9%) died, and (7.9%) left against medical devices (6). Also, Ayder Hospital Ethiopia results showed 16 (4%) of patients were candidates for MV, and 3.5% of them were intubated, with 35.7% dying (9, 14). The difference might be due to poor health service in Ethiopia because of the limited health professionals, poor training, and lack of adequate medical equipment. During the study period, 317 patients admitted to the PICU. Of these, 190 (59.9%) patients transferred to the ward, and the mortality rate was 39.3%. The main cause of death was cardiovascular disease (25.6%), followed by respiratory disease (20.0%). As in Pakistan, it shows there were 45 deaths, giving an overall mortality of 14%. The patients (23/45) were transferred from ward (9), in Nepal. Out of 230 admitted children, 12.6% died, 8.2% left against medical advice, and 2% were referred to other centers (7).
The mortality rate was higher in patients who had an admission diagnosis of cardiovascular disease by three times than in other system classifications. The mortality rate was higher in patients who used mechanical ventilators by four times than in those who didn’t require mechanical ventilators, which is comparable to an Ayder hospital study that found patients who used MV were 17.6 times more likely to die than those who did not (14). This could be due to health professionals lacking adequate knowledge and practice with mechanical ventilators, as well as the hospital failing to provide guidelines on how to use mechanical ventilators.
Age and sex were not statistically significant risk factors for mortality. This is also in line with a study conducted in Ayder hospital that showed that age and gender were not statistically significant risk factors for mortality (19).