Clinical characteristics and mortality risk prediction in critically ill children in Malaysian Borneo

Area of Science:

• Pediatric Intensive Care
• Clinical Epidemiology
• Healthcare Quality Benchmarking

Background:

• Mortality risk prediction scores are crucial for assessing quality of care in pediatric intensive care units (PICUs).
• Benchmarking PICU outcomes against established scores like the Pediatric Index of Mortality 2 (PIM2) is essential for quality improvement.
• Understanding demographic and diagnostic differences between patient populations (e.g., Malaysian vs. immigrant children) can inform targeted interventions.

Purpose of the Study:

• To benchmark PICU outcomes at Sabah Women's and Children's Hospital using the PIM2 score.
• To evaluate differences in admission diagnoses and patient outcomes between Malaysian and immigrant children.
• To assess the applicability of the PIM2 score in a Malaysian PICU setting.

Main Methods:

• Prospective collection of demographic and clinical data from pediatric medical patients admitted to the PICU.
• Calculation of the PIM2 risk score for mortality for all eligible patients.
• Analysis of patient demographics, admission diagnoses, and mortality, comparing Malaysian and non-Malaysian children.

Main Results:

• The study included 115 patients, with a mean age of 2.6 years; 79% were under five.
• Respiratory disorders were the leading diagnosis on admission (37%).
• Infants under two years old with comorbidities showed a significantly higher mortality risk (SMR 2.61).

Conclusions:

• The patient profile in this Malaysian PICU is comparable to other Asian PICUs.
• The PIM2 score demonstrates utility as a mortality risk prediction model for this specific population.
• While overall benchmarking showed no significant deviation, specific subgroups like young infants with comorbidities require focused attention.