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Children with dermatological conditions admitted to paediatric intensive care: analysis of a national clinical audit
S M C George1, S M Sen2, D A Harrison3
1Department of Dermatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Insights
Dermatological conditions are common in pediatric intensive care units (PICUs), with skin infections and inflammatory issues being most frequent. These skin issues significantly impact patient care and outcomes in pediatric intensive care.
Area of Science:
- Pediatric Dermatology
- Intensive Care Medicine
- Epidemiology
Background:
- Limited research exists on dermatological conditions in pediatric intensive care units (PICUs).
- Understanding these conditions is crucial for comprehensive patient care in critical settings.
Purpose of the Study:
- To characterize the spectrum of dermatological disorders in children admitted to UK and Ireland PICUs.
- To determine the frequency and impact of skin conditions on PICU admissions and outcomes.
Main Methods:
- Analysis of data from the Paediatric Intensive Care Audit Network (PICANet) between 2002 and 2010.
- Inclusion of 999 admissions from 882 children, representing 0.8% of all PICU admissions.
Main Results:
- The most prevalent dermatological conditions were skin infections (e.g., cellulitis, necrotizing fasciitis) and inflammatory disorders.
- Dermatological diagnoses were the primary reason for PICU admission in 28% of cases, a manifestation of systemic disease in 35%, and incidental in 37%.
- Overall mortality was 5.2%, comparable to the general PICU population, but higher in children with vascular/hematological conditions.
Conclusions:
- Dermatological conditions represent a significant, though understudied, aspect of pediatric intensive care.
- Skin infections and inflammatory conditions are key concerns requiring attention in PICUs.
- The etiology of dermatological conditions varies, impacting their role in PICU admission and prognosis.
Abstract:
There is little published literature about dermatological conditions in paediatric intensive care units (PICUs). The aim of this study was to describe the range of skin disorders in children admitted to PICUs in the UK and Ireland using data from a national audit. An analysis was conducted using data for 2002 - 2010 from the Paediatric Intensive Care Audit Network (PICANet). In total, 999 admissions of 882 children were identified, representing 0.8% of all PICU admissions. The most frequent dermatological conditions were skin infections, including cellulitis and necrotizing fasciitis, and inflammatory conditions. In 28% of cases, the dermatological diagnosis was considered the reason for PICU admission, in 35% it was a manifestation of systemic disease and in 37% it was considered incidental. Overall mortality was similar to the general PICU population, with 52 deaths (5.2%), but was greater in children with vascular/haematological conditions.
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