Demographic profile and outcome analysis of pediatric intensive care patients
E Volakli1, M Sdougka1, M Tamiolaki1
1Pediatric Intensive Care Unit, Hippokratio General Hospital, Thessaloniki, Greece.
Insights
This study analyzed pediatric intensive care unit (PICU) patients in Greece, finding that while the demographic profile matched other studies, the case mix and disease severity differed. Key mortality predictors included high PRISM III-24 scores and inotropic use.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Epidemiology
Background:
- Pediatric intensive care unit (PICU) patient demographics and outcomes can exhibit significant variability.
- Understanding these variations is crucial for optimizing patient care and resource allocation.
- This study aimed to characterize the demographic profile and outcomes of patients within a Greek PICU setting.
Purpose of the Study:
- To analyze the demographic profile of patients admitted to a Greek PICU.
- To identify key factors influencing patient outcomes, including mortality.
- To compare the findings with existing literature on PICU populations.
Main Methods:
- A prospective observational study was conducted.
- Data collected included patient demographics, comorbidities, diagnoses, severity scores (PRISM III-24, GCS, ISS), procedures, treatments, mechanical ventilation (MV) use, and length of stay (LOS).
- Statistical analyses involved t-tests, Mann-Whitney U, Kruskal-Wallis, chi-squared tests, and Cox regression.
Main Results:
- 300 patients (196 boys/104 girls) were studied, with respiratory failure, head trauma, and seizures as primary diagnoses.
- The actual PICU mortality rate was 9.7%, which was lower than predicted (11.16%).
- Independent predictors of mortality identified through Cox regression were a high Pediatric Risk of Mortality (PRISM III-24) score and inotropic use.
Conclusions:
- The demographic profile of the Greek PICU cohort was similar to other studies, but significant differences in case mix and disease severity were observed.
- The observed mortality rate of 9.7% was relatively high but better than predicted, aligning with the population's characteristics.
- Factors such as inotropic use and PRISM III-24 score are critical for predicting mortality in this PICU population.
Background:
Demographic profile and outcome can vary in pediatric intensive care unit (PICU) patients. The aim of our study was to analyze demographic profile and outcome in a Greek PICU.
Methods:
Prospective observational study.
Data Collected:
demographic profile; co morbidities; source and diagnosis at admission; Pediatric Risk of Mortality (PRISM III-24); Glasgow Coma Scale (GCS, pediatric); Injury Severity Score (ISS); procedures; treatment; mechanical ventilation (MV); MV days; length of stay (LOS) and the outcome at PICU discharge.
Statistical Analysis:
Student's t-test; Mann-Whitney U test; Kruskall-Wallis test; χ(2) criterion with relative risk (RR) estimation; Cox regression analysis; as appropriate. Values are mean ± SD, p < 0.05.
Results:
300 patients (196 boys/104 girls), aged 54.26 ± 49.93 months, were admitted due to respiratory failure (22.3%), head trauma (15.3%), seizures (13.7%), coma (9.7%), postoperative care (7.7%), polytrauma (7%), accidents (5.3%), sepsis-septic shock (5.3%), cardiovascular diseases (4.7%), metabolic diseases (3.3%), multiple organ failure syndrome (3%) and miscellaneous diseases (2.7%). PRISM III-24 score was 8.97 ± 7.79 and predicted mortality rate was 11.16% ± 18.65. MV rate was 67.3% (58.3% at admission) for 6.54 ± 14.45 days, LOS 8.85 ± 23.28 days and actual PICU mortality rate 9.7%. Patients who died had statistically worse severity scores. Significant mortality risk factors were inotropic use, PRISM III-24 > 8, MV, arterial and central venous catheterization, nosocomial infections, complications, and cancer. COX regression analysis showed that PRISM III-24 score and inotropic use were independent predictors of mortality.
Conclusions:
Demographic profile followed similar patterns to relevant studies while there were major differences in case mix and the severity of the disease. Mortality rate (9.7%) was relatively high but better than predicted and in accordance with the characteristics of our population.
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