{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:52:34Z","timestamp":1787943154214,"version":"build-2784847793"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The goal of a pediatric intensive care unit is to treat life-threatening illnesses. Yet, there is a lack of data on survival rates and factors influencing survival in pediatric intensive care units (PICUs) in low-income countries like Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The purpose of this study was to evaluate survival and its predictors in the pediatric intensive care unit of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Method<\/jats:title>\n<jats:p>A retrospective cohort study was implemented on a total of 223 patients admitted to the PICU from September 2019 to August 2020. Using a checklist, trained healthcare workers gathered secondary data from patient charts. The dependent variable was time-to-death. EpiData 4.6 and STATA 16 were used for data entry and data analysis, respectively. Descriptive statistics, cumulative incidence, incidence density, median survival time, and adjusted hazard ratio were calculated to describe variables, estimate mortality rate and risk, and identify factors associated with survival. P&lt;0.05 was used to declare a statistically significant relationship.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Result<\/jats:title>\n<jats:p>A total of 46 (20.6%) deaths were recorded in this study. The cumulative incidence of death was higher in patients transferred from the ward to the intensive care unit (34.7%). The death rate was higher in patients with cardiac problems (40.0%), followed by oncological diseases (35.0%) and infectious diseases (27.9%). The adjusted risk of death was 3.3 times higher in pediatric patients with heart problems than in patients without heart problems. Again, the adjusted risk of death in children with a Glasgow Coma Scale (GCS) of 9 to 14 and a GCS below 9 was 2.2 and 2.5 times higher, respectively, than in children with a GCS of 15. Finally, children with endotracheal tubes were about five times more likely to die than children without endotracheal tubes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>It\u2019s critical to diagnose and treat cardiac issues in pediatric patients as early as possible. Patients with low GCS scores require careful observation. Alternative strategies should be taken into consideration in order to lessen the need for endotracheal tubes and enhance results.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315863","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T18:35:41Z","timestamp":1739385341000},"page":"e0315863","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of survival in pediatric intensive care unit in a low-income country: A retrospective cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-2579","authenticated-orcid":true,"given":"Mohamedawel Mohamedniguss","family":"Ebrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdikarin Ahmed","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6591-9663","authenticated-orcid":true,"given":"Mohammed Mustefa","family":"Mohammedamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"pone.0315863.ref001","first-page":"73","volume-title":"Neonatal intensive care.","author":"G Haglund","year":"1976"},{"key":"pone.0315863.ref002","first-page":"1","volume-title":"Overview of pediatrics. Nelson Textbook of Pediatrics. 21st ed","author":"R.M. Klieg","year":"2020"},{"key":"pone.0315863.ref003","first-page":"292","article-title":"\"A prospective audit of costs of intensive care in cancer patients in India.\"","author":"Atul P. Kulkarni","year":"2013","journal-title":"Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine 17.5"},{"key":"pone.0315863.ref004","year":"2017","journal-title":"World Bank Database [Online],"},{"key":"pone.0315863.ref005","unstructured":"WHO. Children: reducing mortality. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/children-reducing-mortality [Accessed 1 May 2020]."},{"issue":"1","key":"pone.0315863.ref006","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.21608\/ejhm.2023.282507","article-title":"Predictors of Outcome in an Egyptian Pediatric Intensive Care Unit","volume":"90","author":"Ramadan A. Mahmoud","year":"2023","journal-title":"The Egyptian Journal of Hospital Medicine"},{"key":"pone.0315863.ref007","doi-asserted-by":"crossref","first-page":"11795565231169498","DOI":"10.1177\/11795565231169498","article-title":"Survival Status and Predictors of Mortality Among Patients Admitted to Pediatric Intensive Care Unit at Selected Tertiary Care Hospitals in Ethiopia: A Prospective Observational Study","volume":"17","author":"Bacha","year":"2023","journal-title":"Clinical Medicine Insights: Pediatrics"},{"key":"pone.0315863.ref008","doi-asserted-by":"crossref","first-page":"e036746","DOI":"10.1136\/bmjopen-2019-036746","article-title":"Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: a prospective observational cohort study","volume":"10","author":"NW Teshager","year":"2020","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0315863.ref009","first-page":"1","article-title":"Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study.\"","volume":"22","author":"Ashenafi Seifu","year":"2022","journal-title":"BMC anesthesiology"},{"issue":"10","key":"pone.0315863.ref010","doi-asserted-by":"crossref","first-page":"e003109","DOI":"10.1136\/bmjgh-2020-003109","article-title":"Childhood morbidity and its determinants: evidence from 31 countries in sub-Saharan Africa","volume":"5","author":"ST Adedokun","year":"2020","journal-title":"BMJ Global Health"},{"issue":"10","key":"pone.0315863.ref011","doi-asserted-by":"crossref","first-page":"e036746","DOI":"10.1136\/bmjopen-2019-036746","article-title":"Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: a prospective observational cohort study","volume":"10","author":"NW Teshager","year":"2020","journal-title":"BMJ open"},{"issue":"07","key":"pone.0315863.ref012","first-page":"2022","article-title":"Morbidity profile and outcome in a paediatric intensive care unit of a tertiary care hospital over a one-year period: a single institution study from rural India. Author names and affiliations","volume":"9","author":"JK Jana","year":"2022","journal-title":"European Journal of Molecular & Clinical Medicine"},{"key":"pone.0315863.ref013","doi-asserted-by":"crossref","first-page":"926686","DOI":"10.3389\/fped.2022.926686","article-title":"Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III scores in tertiary pediatric intensive unit in Saudi Arabia","volume":"10","author":"AS Alkhalifah","year":"2022","journal-title":"Frontiers in Pediatrics"},{"issue":"6","key":"pone.0315863.ref014","first-page":"1657","article-title":"Clinical profile and outcome in a paediatric intensive care unit of a tertiary care hospital in pakistan","volume":"70","author":"F Basheer","year":"2020","journal-title":"Pakistan Armed Forces Medical Journal"},{"issue":"1","key":"pone.0315863.ref015","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.21608\/ejhm.2023.282507","article-title":"Predictors of Outcome in an Egyptian Pediatric Intensive Care Unit.","volume":"90","author":"RA Mahmoud","year":"2023","journal-title":"The Egyptian Journal of Hospital Medicine"},{"issue":"1","key":"pone.0315863.ref016","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12871-021-01556-7","article-title":"Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study","volume":"22","author":"A Seifu","year":"2022","journal-title":"BMC anesthesiology"},{"key":"pone.0315863.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-018-3432-4","article-title":"Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia, 2015.","volume":"11","author":"H Haftu","year":"2018","journal-title":"BMC research notes."},{"issue":"4","key":"pone.0315863.ref018","doi-asserted-by":"crossref","DOI":"10.5812\/zjrms.63006","article-title":"The main causes of mortality in pediatric intensive care unit in south west of Iran","volume":"20","author":"E Valavi","year":"2018","journal-title":"Zahedan Journal of Research in Medical Sciences"},{"issue":"4","key":"pone.0315863.ref019","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MPH.0000000000001616","article-title":"Prognostic factors of ICU mortality in pediatric oncology patients with pulmonary complications","volume":"42","author":"K Kim","year":"2020","journal-title":"Journal of Pediatric Hematology\/Oncology"},{"issue":"1","key":"pone.0315863.ref020","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3126\/jngmc.v17i1.25305","article-title":"Prediction of mortality by pediatric risk of mortality (PRISM) III score In NGMC pediatric intensive care unit","volume":"17","author":"R. Bora","year":"2019","journal-title":"Journal of Nepalgunj Medical College"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T18:35:49Z","timestamp":1739385349000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315863"}},"subtitle":[],"editor":[{"given":"Patricia Rezende","family":"do Prado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,12]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0315863","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,12]]}}}