Predictors of Mortality Among Pediatric Patients Admitted to Intensive Care Units in Eastern Amhara, Ethiopia: A Prospective Multi-Center Cohort Study

Abstract

Background: Ethiopia remains among the 5 countries with the highest under-five mortality, yet prospective multicenter data on pediatric intensive care unit (PICU) outcomes are limited. Objective: To determine the incidence and predictors of mortality among children admitted to PICUs in Eastern Amhara. Methods: A prospective observational study was conducted on 240 children admitted to tertiary-level PICUs between February and April 2025. Kaplan-Meier analysis estimated survival probabilities, and Cox proportional hazards regression identified independent predictors of mortality. Results: Fifty-eight deaths (24.2%) occurred. Rural residence (AHR: 2.0, 95% CI: 1.2-3.5), the use of inotropic agents (AHR: 2.0, 95% CI: 1.2-3.5) consciousness level (GCS <8; AHR: 2.3, 95% CI: 1.2-4.4), presence of comorbidities (AHR: 1.9, 95% CI: 1.1-3.4) were associated increased mortality. Conclusion: PICU mortality was high, especially among rural children, those with severe neurological impairment, comorbidities, or requiring inotropes, emphasizing early identification and close monitoring of high-risk patients.