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[A unique population in today's paediatric intensive care unit: Immigrant children presenting with infectious
Ayse Filiz Yetimakman1, Eylem Kıral2
1Servicio de Cuidados Intensivos Pediátricos, Universidad de Kocaeli, Kocaeli, Turquía.
Insights
Immigrant children in pediatric intensive care had higher mortality rates, particularly from community-acquired infections, despite similar disease severity scores. Further research is needed to understand these disparities.
Area of Science:
- Pediatric critical care medicine
- Public health disparities
- Epidemiology of childhood diseases
Background:
- Higher crude death rates observed in immigrant children compared to native children in a pediatric intensive care unit (PICU).
- Discrepancy in mortality despite similar disease severity scores between immigrant and native pediatric patients.
Purpose of the Study:
- To compare descriptive data and standardized mortality ratios (SMR) between immigrant children and native children.
- To analyze differences in mortality and identify potential contributing factors in a PICU setting.
Main Methods:
- Retrospective study comparing demographic characteristics, diagnostic data, disease severity scores, and mortality.
- Inclusion of medical and surgical patients admitted over one year (n=1283).
- Comparison between immigrant children of Syrian descent and children of Turkish descent.
Main Results:
- Higher mortality observed in the immigrant group (16% vs. 11%) despite similar Pediatric Risk of Mortality (PRISM) scores.
- Increased mortality in immigrant children with community-acquired infectious diseases (19.3% vs. 9.8%).
- Standardized Mortality Ratio (SMR) was higher in the immigrant group (0.4) compared to the Turkish group (0.24).
Conclusions:
- An association exists between community-acquired infectious disease and increased mortality in the immigrant pediatric population.
- The underlying mechanisms for increased mortality in immigrant children require further investigation.
- Potential need to incorporate infection-related parameters into severity scores for this specific population.
Introduction:
Despite similar disease severity scores; we found a higher crude death rate in the group of immigrant children compared to the group of native children in a paediatric intensive care unit. Our study aimed to compare descriptive data and standardised mortality ratios (SMR) in order to analyse differences in mortality.
Material And Methods:
We conducted a retrospective study comparing demographic characteristics, diagnostic data, disease severity scores and mortality in immigrant children of Syrian descent and children of Turkish descent. We included data for the medical and surgical patients admitted in 1 year. The sample included 1283 patients.
Results:
We compared the age and sex distribution, presence of underlying disease, frequency of community-acquired infectious diseases, length of say, PRISM scores, SMR and crude death rates in the 2 groups. There were 1077 patients in the Turkish group and 206 patients in the immigrant group. The proportion of patients with underlying disease was greater in the Turkish group (42% vs. 37.4%). The proportion of patients with a community-acquired infectious disease as the presenting complaint was similar in both groups (52.9% vs. 47.4%). The mortality in patients with infectious disease was higher in the immigrant group (19.3% vs. 9.8%). There was not significant difference in the mean PRISM score between the 2 groups. We found a higher mortality in the immigrant group (16% vs. 11%). The standardised mortality ratio was 0.32 in the total sample group; 0.4 in the immigrant group and 0.24 in the Turkish group.
Conclusions:
In our study, we found an association between community-acquired infectious disease and increased mortality in the immigrant group. The underlying mechanism for this increase remains to be explained and further research is required to determine whether parameters related to infection should be added to this severity score for its use in this specific population.
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