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

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*10 6 /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.