Time to death and its determinants among neonates admitted to the Neonatal Intensive Care Unit (NICU) of Woldia Comprehensive Specialized Hospital, Amhara region, northeast Ethiopia: A five-year retrospective study

Abstract

Background: Despite an effort to reduce neonatal mortality, Ethiopia is still the leading among the countries with the highest neonatal death. While there have been studies conducted on the overall neonatal mortality rate, there is limited research specifically focusing on the time to death of neonates admitted to the Neonatal Intensive Care Unit (NICU). Objectives: To assess the survival time of neonatal death (time to death) and its determinants for neonates admitted to the NICU of Woldia Comprehensive Specialized Hospital (WCSH). Methods: A retrospective cohort study was conducted among 604 neonates admitted to the NICU of Woldia comprehensive specialized hospital from January 2018 to December 2022. The data were entered using Epi-Data version 4.6 and analysis was made using STATA version 14 software. To estimate failure probability, the Kaplan-Meier curve and life table estimate were calculated. The log-rank test was used to examine differences in death rates among different categories. The Cox proportional hazards model was employed to identify determinant variables. In the multivariate Cox analysis, variables with a hazard ratio p-value < 0.05 were considered statistically significant at a 95% confidence interval. Results: The findings of the study indicate that a total of 604 neonates were included and observed for a cumulative period of 3416 neonate-days. The median time to death among the neonates was 14 days. Out of the reviewed cases, 117 (19.37%) neonates died during the study period. Have no ANC checkup (AHR: 1.68; 95% CI: 1.12-2.52), having bad obstetrics history (AHR: 1.99, 95% CI: 1.28-3.10), having sepsis (AHR: 1.87, 95% CI: 1.23-2.86) and having asphyxia (AHR: 1.64, 95% CI: 1.05-2.58) were increased the hazard of neonatal death. Conclusion: The overall neonatal mortality incidence was high. ANC checkup, bad obstetrics history, and specific diagnoses, were found to significantly influence the hazard of neonatal mortality. Increase awareness and education programs for the community regarding the importance of ANC visits. Implement protocols for early identification and management of respiratory distress, sepsis and prenatal asphyxia is critical.