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[Care of critically-ill children in Asturias (Spain): characteristics and effectiveness]
A Medina Villanueva1, A Concha Torre, C Rey Galán
1Unidad de Cuidados Intensivos Pediátricos. Hospital Central de Asturias. Universidad de Oviedo. España.
Insights
This study evaluated a pediatric intensive care unit
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Healthcare Quality Assessment
Background:
- The Pediatric Intensive Care Unit (PICU) at Hospital Central de Asturias, Spain, has provided critical care services for five years.
- Understanding the unit's performance and patient demographics is crucial for optimizing care delivery.
Purpose of the Study:
- To characterize the patient population and clinical work within the PICU.
- To evaluate the effectiveness of the care provided using mortality data and risk scores.
Main Methods:
- A prospective study analyzed critically-ill children admitted between 1996 and 2000.
- Effectiveness was measured by comparing observed to expected mortality, calculated using the Pediatric Risk of Mortality (PRISM) score.
Main Results:
- The study included children with a median age of 38 months, with respiratory, neurological, and infectious diseases being common admissions.
- Overall mortality was 4.3%, with care effectiveness varying by disease category but showing improvement over time.
- Patient severity and resource utilization, including mechanical ventilation, increased during the study period.
Conclusions:
- The analysis of PICU data is valuable for assessing and enhancing the quality of care in pediatric critical care settings.
- Continuous evaluation of PICU performance is essential for improving patient outcomes.
Objective:
To describe the work performed in the Pediatric Intensive Care Unit of the Hospital Central de Asturias (Spain) in its first 5 years and to assess the effectiveness of the care provided.
Methods:
A prospective study of the characteristics of critically-ill children admitted from 1996 to 2000 was performed. Effectiveness was defined as the ratio of observed to expected mortality, determined by pediatric risk of mortality (PRISM) score calculated 24 hours after admission.
Results:
The median age of critically-ill children was 38 months and the mean length of stay was 6.8 days. Forty percent of the patients were transferred from other hospitals in Asturias and Leon. The most frequent causes of admission were respiratory, neurological and infectious diseases, and trauma. Overall mortality was 4.3 %. Over the years the severity of the patients increased with a consequent rise in mean length of stay, use of central venous access and mechanical ventilation. Forty-two percent of deaths were expected. The effectiveness of care was high among high-risk patients, among those with respiratory and metabolic diseases and in the postoperative period but was low among patients with hematologic and gastrointestinal diseases. Effectiveness increased over time.
Conclusions:
Studies analyzing pediatric intensive care units are useful for assessing and improving the effectiveness of care in these centers.
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