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Risk factors associated with death in children admitted to a paediatric intensive care unit
de Freitas Aragão1, M de Fátima, P M Albuquerque
1Instituto Materno Infantil de Pernambuco, Universidade Federal de Pernambuco, Recife, Brazil.
Insights
Young children (under 2) in pediatric intensive care units (PICUs) face higher mortality risks. Key factors include mechanical ventilation, hospital-acquired infections, and short hospital stays, aiding in identifying high-risk pediatric patients.
Area of Science:
- Pediatric Intensive Care
- Clinical Epidemiology
- Hospital-Acquired Infections
Background:
- Identifying risk factors for mortality in pediatric intensive care units (PICUs) is crucial for improving patient outcomes.
- The Instituto Materno Infantil de Pernambuco in Recife, Brazil, serves as a key referral center for critically ill children.
Purpose of the Study:
- To identify fatal risk factors for children admitted to a pediatric intensive care unit (PICU) in Recife, Brazil.
- To inform strategies for managing pediatric patients with poor prognoses.
Main Methods:
- A survey was conducted from June 1996 to January 1997.
- Risk factors were quantified using crude and adjusted odds ratios.
- Statistical significance was tested using 95% confidence intervals, likelihood ratio statistics, and p-values (p < 0.05).
Main Results:
- Children under 2 years old showed an increased risk of death.
- Use of mechanical ventilation and central venous catheters were associated with higher mortality.
- Hospital-acquired infections, short hospital stays (≤2 days), and high clinical severity (Class 4 CCS) were significant risk factors for death.
Conclusions:
- Age below 2 years, invasive procedures (mechanical ventilation, central venous catheter), hospital-acquired infections, and short hospital stays are critical risk factors for mortality in PICU patients.
- High clinical severity (Class 4 CCS) is a significant predictor of death in this pediatric population.
- These findings enable the identification of high-risk children, potentially improving the management of critically ill pediatric patients.
Abstract:
The aim of this study was to identify fatal risk factors for children admitted to the paediatric intensive care unit of the Instituto Materno Infantil de Pernambuco, a referral hospital in Recife, a city in the north-east of Brazil. A survey was performed from June 1996 to January 1997. Risk was quantified by the crude and adjusted odds ratio. The 95 per cent confidence interval, likelihood ratio statistics, and the probability (p < 0.05) value were used to test for statistical significance. An association was established between death in children admitted to the paediatric intensive care unit and: (1) age below 2 years old; (2) use of mechanical ventilation and central venous catheter; (3) presence of hospital-acquired infection; (4) length of hospital stay of 2 days or less; and (5) Class 4 clinical severity, according to the Clinical Classification System (CCS). These results allow the identification of the children with a greater risk of death and may contribute to improvements in handling groups of patients with poor prognosis.