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Short-term and long-term mortality following pediatric intensive care

Eleni A Volakli1, Maria Sdougka, Vasiliki Drossou-Agakidou

  • 1Department of Pediatric Intensive Care, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece. elenavolakli@gmail.com

Pediatrics International : Official Journal of the Japan Pediatric Society
|December 16, 2011
PubMed

Insights

This study tracked mortality in pediatric intensive care unit (PICU) patients for two years. Critical illness severity predicts short-term deaths, while comorbidity predicts long-term mortality in these children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Epidemiology
  • Outcomes Research

Background:

  • Assessing mortality after pediatric intensive care unit (PICU) discharge is crucial for understanding patient outcomes.
  • Short-term and long-term survival rates require distinct analytical approaches.
  • Identifying predictors of mortality informs clinical management and resource allocation.

Purpose of the Study:

  • To investigate short-term and long-term mortality patterns in patients discharged from the pediatric intensive care unit (PICU).
  • To identify risk factors associated with mortality at various time points post-PICU discharge.
  • To determine the optimal follow-up duration for comprehensive mortality assessment in PICU survivors.

Main Methods:

  • Prospective observational study design.
  • Inclusion of 300 pediatric patients with comprehensive data collection on demographics, severity scores (PRISM III-24), interventions (mechanical ventilation, catheterization), and length of stay.
  • Mortality assessment at PICU discharge, hospital discharge, and at 3 months, 6 months, 1 year, and 2 years post-discharge.

Main Results:

  • The study included 300 patients; the median PRISM III-24 score was 7, with a predicted mortality of 11.16%.
  • Overall mortality rates were 9.7% at PICU discharge and 19.0% at 2 years.
  • Key predictors of mortality included inotrope use, high PRISM III-24 scores, mechanical ventilation, invasive procedures, nosocomial infections, complications, and cancer. Comorbidity and cancer were significant predictors of 2-year mortality.

Conclusions:

  • A 2-year follow-up period is adequate for evaluating mortality in pediatric intensive care unit patients.
  • Severity of critical illness is the primary determinant of short-term mortality.
  • Comorbidity emerges as the major factor influencing long-term mortality in this population.
Abstract

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