Related Experiment Video
Updated: Feb 17, 2026
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Five-Year Survival and Causes of Death in Children After Intensive Care-A National Registry Study
Elina Kyösti1,2,3, Janne H Liisanantti1,2,3, Outi Peltoniemi4
1Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.
Insights
Children admitted to intensive care units (ICUs) face a higher long-term mortality risk, with cancer and neurological diseases being leading causes of death post-discharge. This contrasts with trauma as the primary cause in the general pediatric population.
Area of Science:
- Pediatric critical care medicine
- Long-term health outcomes
- Epidemiology of childhood diseases
Background:
- Intensive care unit (ICU) admission significantly impacts a child's long-term health.
- Understanding post-ICU mortality patterns is crucial for improving pediatric care.
- Previous studies have not fully elucidated long-term survival and causes of death in children after ICU discharge.
Purpose of the Study:
- To compare long-term mortality rates and causes of death in children following intensive care unit (ICU) admission with a matched control population.
- To identify specific medical conditions contributing to mortality in pediatric ICU survivors.
- To analyze the temporal trends in mortality after ICU discharge.
Main Methods:
- A longitudinal follow-up registry study utilizing national ICU and hospital data.
- Inclusion of all children admitted to an ICU between 2009 and 2010.
- Comparison of mortality data with a control cohort of over 1 million children from the general population, with a median follow-up of 4.9 years.
Main Results:
- The standardized mortality rate for children admitted to the ICU was significantly higher (53.4) compared to the control group (0.10%).
- One-year cumulative mortality for discharged ICU patients was 3.3%.
- Among survivors discharged from the ICU, the leading causes of death were cancer (35.3%), neurological diseases (17.6%), and metabolic disorders (11.7%), contrasting with trauma (45.3%) in the control group.
Conclusions:
- Pediatric ICU survivors exhibit an elevated risk of mortality for up to three years post-discharge.
- Medical conditions, particularly cancer and neurological disorders, are the predominant causes of death in children who survive the initial ICU stay.
- The findings underscore the need for continued monitoring and specialized care for pediatric ICU alumni.
Objectives:
The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age.
Design:
Longitudinal follow-up study.
Setting:
Registry study of a national ICU register and hospital registries.
Patients:
Children admitted to an ICU in the years 2009 and 2010.
Interventions:
None.
Measurements And Main Results:
The mortality and causes of death following ICU discharge were analyzed retrospectively. The median follow-up period was 4.9 years (25-75th percentiles, 4.4-5.5 yr). The causes of death in survivors 30 days after ICU discharge were compared with a cohort of 1 million children of the general population of same age. In total, 2,792 children were admitted to an ICU during the study period. Of those, 53 (1.9%) died in the ICU and 2,739 were discharged. Thirteen children died within 30 days of discharge, and 68 died between 30 days and the end of follow-up (December 31, 2014). In the control population (n = 1,020,407 children), there were 1,037 deaths (0.10%) from 2009 to 2014. The standardized mortality rate for the children admitted to the ICU during the study period was 53.4 (95% CI, 44.7-63.2). The standardized mortality rate for those children alive 1 year after discharge was 16.7 (12.1-22.6). One-year cumulative mortality was 3.3%. The most common causes of death in subjects alive 30 days post ICU were cancer (35.3%), neurologic (17.6%), and metabolic diseases (11.7%), whereas trauma was the most common cause in the control group (45.3%).
Conclusions:
There was an increased risk of death in a cohort of ICU-admitted children even 3 years after discharge. In those who survived 30 days after discharge, medical causes of death were dominant, whereas deaths due to trauma were most common in the control group.
Related Concept Videos
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:20Actuarial Approach
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
01:30Acute Respiratory Failure-III
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:21Cancer Survival Analysis