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Mortality Rate and Risk Factors in Pediatric Intensive Care Unit of Imam Hossein Children's Hospital in Isfahan: A
Fatemeh S Hajidavalu1, Atefeh Sadeghizadeh2
1School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
This study identified key risk factors for mortality in a pediatric intensive care unit (PICU) in Iran. Readmission and resuscitation history were significant predictors of mortality in critically ill children.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Epidemiology
Background:
- Pediatric intensive care units (PICUs) are critical for managing critically ill children.
- Understanding mortality rates and risk factors in PICUs is essential for improving patient outcomes.
- This study focuses on a major referral pediatric hospital in Iran.
Purpose of the Study:
- To determine the prevalence of mortality in the PICU of Imam Hossein Children's Hospital.
- To identify significant risk factors associated with mortality in this pediatric population.
- To provide data for improving critical care strategies in the region.
Main Methods:
- A retrospective study of 311 patients admitted to the PICU over 9 months.
- Data collected included demographics, causes of admission, Pediatric Risk of Mortality (PRISM)-III score, and morbidities.
- Key outcomes assessed were mortality, readmission, and complications like Acute Kidney Injury (AKI) and Multiple Organ Dysfunction Syndrome (MODS).
Main Results:
- The overall mortality rate was 12.2%.
- Significant risk factors for mortality included readmission, history of resuscitation, and a higher PRISM-III score.
- Complications such as AKI, hypoglycemia, MODS, disseminated intravascular coagulation (DIC), and prolonged mechanical ventilation were strongly correlated with mortality.
Conclusions:
- The PICU mortality rate of 12.2% is comparable to rates in other developing countries.
- Readmission, resuscitation history, PRISM-III score, and specific complications (AKI, ARDS, DIC, MODS, hypoglycemia) are critical factors influencing mortality.
- These findings highlight the need for targeted interventions to reduce mortality in critically ill pediatric patients.
Background:
Various studies have conducted to report the mortality rates and its risk factors in pediatric intensive care unit. This study aimed to determine the mortality prevalence and risk factors in PICU of Imam Hossein Children's Hospital in Isfahan, which is the main referral pediatric hospital in the center of Iran.
Materials And Methods:
This study was performed on 311 patients during a period of 9 months. The questionnaire which included age, gender, length of stay in the PICU and hospital, mortality, history of resuscitation in other wards and readmission, the causes and sources of hospitalization, pediatric risk of mortality (PRISM)-III score, respiratory supports, morbidities like nosocomial infections, acute kidney injury (AKI), multiple organ dysfunction syndrome (MODS) confirmed by pediatric sequential organ failure assessment score (P-SOFA) and glycemic disorders was filled out.
Results:
One hundred and seventy-seven (56.9%) were males and 103 (33%) were belonged to the age group of 12-59 months. The most prevalent causes of hospitalization were status epilepticus (12.9%) and pneumonia (11.2%). Mortality rate was 12.2%. The significant factors associated with mortality were readmission and history of resuscitation. PRISM-III index showed a significant difference between nonsurvivors and survivors (7.05 ± 6.36 vs. 3.36 ± 4.34, P = 0.001). Complications like AKI, hypoglycemia, MODS and disseminated intravascular coagulation (DIC), length of mechanical ventilation significantly correlated with mortality.
Conclusions:
Mortality rate was less than that of other developing countries (12.2%) and this was associated with some risk factors included readmission, history of resuscitation, PRISM-III Index; complications like AKI, acute respiratory distress syndrome (ARDS), DIC, mechanical ventilation duration, MODS, hypoglycemia, and P-SOFA index.
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