Time to death and its predictors among neonates admitted to the neonatal intensive care unit at Boru Meda General Hospital, Northeast Ethiopia

Despite all efforts made, neonatal mortality remains a serious public health concern in Ethiopia, particularly in the Amhara region. Identifying the hazard time to death and its predictors plays a crucial role in reducing neonatal mortality. Therefore, this study aimed to determine time to death and its predictors among neonates admitted in the neonatal intensive care unit at Boru Meda General Hospital, northeast Ethiopia, in 2023. This institution -based retrospective cohort study was conducted among 323 neonates in the neonatal intensive care unit at Boru Meda General Hospital from November 20, 2021, to January 30, 2023. The extracted data entered in to epi- info version 7.3, exported to, and analyzed using STATA version 14. Kaplan-Meier failure function and failure probability table computed. A Cox proportional hazard model fitted to identify predictors of time to neonatal death. The hazard ratio with a 95% confidence interval reported, and statistical significance declared at a p-value of ≤ 0.05. The Proportionality assumption tested using a global test based on Schoenfeld residual analysis. Among 323 neonates studied at Boru Meda General Hospital, 28 (8.7%) died. And the overall incidence of neonatal mortality was 12.6 (95% CI: 8.7, 18.2) per 1000 neonate-days with a median time to death of 6 days and a high proportion of premature neonatal deaths of 10 (14.5%), which makes the incidence rate of premature neonatal mortality 17.2 (95% CI: 9.2, 31.9) per 1000 neonate - days. In this study, almost (85.7%) of neonatal deaths occurred within one week of their lives. Hypothermia at admission (AHR: 2.89, CI: 1.12-7.3), respiratory distress (AHR: 2.8, CI: 1.04-7.4), and congenital anomalies (AHR: 5.9, CI: 1.2-28.7) were independent predictors of neonatal mortality. In our study, we found a high rate of early neonatal mortality. Level of body temperature at admissions, respiratory distress, and congenital anomalies were independent predictors of the time to death of neonates. Therefore, an intervention that focuses on the identified predictors had a significant impact to reduce neonatal mortality.