Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the

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Carin W Verlaat1, Nina Wubben2, Idse H Visser3

  • 1Radboud Institute for Health Sciences, Department of Intensive Care Medicine Radboud, university medical center, Internal post 709, P.O. box 9101, 6500HB, Nijmegen, The Netherlands. carin.verlaat@radboudumc.nl.

BMC Pediatrics
|August 8, 2019
PubMed

Insights

Complex chronic conditions (CCCs) do not increase mortality risk in high-risk pediatric intensive care unit (PICU) patients. Higher Glasgow Coma Scale scores at admission were linked to lower mortality in this vulnerable patient group.

Area of Science:

  • Pediatric critical care medicine
  • Clinical epidemiology
  • Patient outcomes research

Background:

  • High-risk patients in the pediatric intensive care unit (PICU) significantly contribute to mortality.
  • Complex chronic conditions (CCCs) are known risk factors for death.
  • The impact of CCCs on mortality specifically within high-risk PICU populations remains unclear.

Purpose of the Study:

  • To investigate the association between complex chronic conditions (CCCs) and mortality in high-risk pediatric intensive care unit (PICU) patients.
  • To identify other factors influencing mortality in this specific patient cohort.

Main Methods:

  • Retrospective cohort study utilizing a national PICU database (2006-2012).
  • Inclusion criteria: Patients under 18 with predicted mortality risk >30% (PRISM or PIM2), excluding those with pre-PICU cardiac arrest.
  • Analysis of 492 high-risk patients, with 39.6% experiencing mortality.

Main Results:

  • No significant association was found between complex chronic conditions (CCCs) and non-survival in high-risk PICU patients (OR 0.99; 95% CI 0.62-1.59).
  • Higher Glasgow Coma Scale scores upon PICU admission were associated with decreased mortality (OR 0.91; 95% CI 0.87-0.96).

Conclusions:

  • Complex chronic conditions (CCCs) are not associated with increased mortality in high-risk pediatric intensive care unit (PICU) patients.
  • Glasgow Coma Scale at admission is a significant predictor of survival in this population.
Abstract

Keywords:
ChildCritical careMortalityOutcome assessment (healthcare)

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