Survival status and predictors of mortality among neonates admitted to intensive care unit in northern Ethiopia; Prospective cohort study

Background Globally, in 2018 about 2.5 million neonates died in the first month of life, and marked disparities exist across regions and countries. Neonatal mortality is a global burden both in developed and developing countries. In Ethiopia, neonatal mortality rate is unacceptably high which is 30/1000 live births. Objective To assess survival status and predictors of mortality among neonates admitted to intensive care unit in Northern Ethiopia. Methods Prospective cohort study was employed among 325 neonates admitted to intensive care unit in Mekelle city from October 2019 to May 2020. Systematic random sampling was used to select study participants. Structured questionnaire were used to collect the required variable. Data were entered and cleaned using Epi-data Version-4.4.3.1 and were exported to STATA Version-14 for analyze. Life table and Kaplan Meir were used to estimate survival time and compare survival curves of neonates. Cox proportional hazard model were fitted with 95% confidence interval and "P<0.05". Results In this study the incidence rate of neonatal mortality was 23.55 per 1000 person-day observation [95%CI:17.40,31.87]. And overall median survival time was 24 days. About 15(35.73%) and 17(40.47%) of neonatal death occurred within 24 hours and 7 days of life respectively. Birth injury (AHR: 2.4;95%CI:1.10,5.70), 1st minute APGAR score <7(AHR:5.5; 95%CI:1.73,17.18), time of rupture of membrane >12 hours (AHR:2.6; 95% CI:1.04, 6.31), out born neonates (AHR:2.93; 95% CI:1.13, 7.58) and meconium aspiration syndrome (AHR: 3.5; 95% CI: 1.39, 8.94) were predictors of neonatal mortality. Conclusions The incidence of neonatal mortality rate was found to be high and neonate with birth injury (trauma), out born neonate, 1st minute APGAR score <7 and time of rupture of membrane >12 hours and Meconium aspiration syndrome were predictors of mortality.