Time to death and its predictors among adults on mechanical ventilation at Hiwot Fana comprehensive specialized hospital, eastern Ethiopia: A retrospective cohort study.

IF 2.2 Q2 MEDICINE, GENERAL & INTERNAL

SAGE Open Medicine Pub Date : 2026-06-17 eCollection Date: 2026-01-01 DOI:10.1177/20503121261460591

Rahma Esmael, Behailu Hawulte Ayele, Adisu Birhanu Weldesenbet

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Abstract

Introduction: Mechanical ventilation is an essential lifesaving intervention for patients with severe illness. Mortality among patients receiving mechanical ventilation is high in low-resource settings, including Ethiopia. Evidence on predictors of time to death in such settings is limited. Therefore, this study aimed to assess time to death and its predictors among adult patients receiving mechanical ventilation in intensive care unit at Hiwot Fana comprehensive specialized Hospital, Eastern Ethiopia.

Method: An institution-based retrospective cohort study was conducted among 586 mechanically ventilated adult patients. Data were collected using structured checklist. Time to event analysis was performed using cox proportional hazards model to identify predictors of time to death. The proportional hazard assumption was assessed using schoenfeld residuals. Adjusted hazard ratios with 95% confidence interval were used to quantify associations.

Results: The incidence density of mortality was 6.74 per 100 person-days observations (95% CI: 5.92-7.68). Factors associated with a higher hazards of death included platelet count less than 150,000*10⁶/L (Adjusted Hazard Ratio (AHR)=1.74, 95% CI: 1.26-2.40), cardiovascular failure during mechanical ventilation (AHR=1.62, 95% CI: 1.08-2.43), cardiopulmonary resuscitation (AHR=2.36, 95% CI: 1.71-3.31), vasopressor use (AHR=2.94, 95% CI: 2.02-4.27), and higher fraction of inspired oxygen at initiation of mechanical ventilation (AHR=1.01, 95% CI: 1.007-1.019) had higher risk of death. Gastrostomy was associated wit lower hazard of death (AHR=0.35, 95% CI: 0.18-0.68).

Conclusion: Several clinical and treatment related factors were associated with time to death among mechanically ventilated Intensive Care Unit (ICU) patients. Close monitoring and appropriate management of high risk patients are essential needed.

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埃塞俄比亚东部Hiwot Fana综合专科医院机械通气成人的死亡时间及其预测因素：一项回顾性队列研究

简介：机械通气是重症患者必不可少的救命干预手段。在包括埃塞俄比亚在内的资源匮乏地区，接受机械通气的患者死亡率很高。在这种情况下预测死亡时间的证据有限。因此，本研究旨在评估埃塞俄比亚东部Hiwot Fana综合专科医院重症监护病房接受机械通气的成年患者的死亡时间及其预测因素。方法：对586例成人机械通气患者进行回顾性队列研究。采用结构化检查表收集数据。使用cox比例风险模型进行时间-事件分析，以确定死亡时间的预测因子。使用舍恩菲尔德残差评估比例风险假设。采用95%置信区间的校正风险比来量化相关性。结果：死亡率发生率密度为6.74 / 100人/日（95% CI: 5.92-7.68）。与较高死亡风险相关的因素包括血小板计数小于150,000*106/L（校正风险比(AHR)=1.74, 95% CI: 1.26-2.40），机械通气期间心血管衰竭（AHR=1.62, 95% CI: 1.08-2.43），心肺复苏（AHR=2.36, 95% CI: 1.71-3.31），血管加压剂的使用（AHR=2.94, 95% CI: 2.02-4.27），机械通气开始时吸氧比例较高（AHR=1.01, 95% CI: 1.007-1.019），死亡风险较高。胃造口术与较低的死亡风险相关（AHR=0.35, 95% CI: 0.18-0.68）。结论：机械通气重症监护病房（ICU）患者的临床及治疗相关因素与死亡时间相关。对高危患者进行密切监测和适当管理是必不可少的。

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