Causes, timing, and modes of death in a tertiary pediatric intensive care unit: Five years' experience

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Mortality analysis

Background:

• Pediatric intensive care units (PICUs) manage critically ill children.
• Understanding causes of death is crucial for improving patient outcomes.
• Tertiary care centers face unique challenges in pediatric critical care.

Purpose of the Study:

• To determine the primary causes, modes, and timing of mortality in a tertiary PICU.
• To analyze mortality patterns in critically ill children.
• To identify areas for intervention to reduce pediatric deaths.

Main Methods:

• Retrospective analysis of patient data from a tertiary PICU in Riyadh, Saudi Arabia.
• Inclusion criteria: patients aged >48 hours to <15 years who died between January 2012 and December 2016.
• Data collected on causes, modes, and timing of death, and infection attribution.

Main Results:

• A total of 101 deaths occurred from 2295 admissions (4.4% crude mortality rate).
• Sepsis (30.7%) was the most common cause of death, followed by lower respiratory tract infections (18.8%) and cardiac diseases (11.9%).
• Failed cardiopulmonary resuscitation (50.5%) and withholding life-sustaining treatment (42.6%) were the most common modes of death. 62.4% of deaths were infection-attributed.

Conclusions:

• Infections continue to be a major contributor to pediatric mortality in PICUs.
• Enhanced infection prevention and early treatment strategies are vital for reducing pediatric deaths.
• There is a need to improve palliative care services and investigate the low rate of brain death diagnoses.