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[Reason for admission and cause of death in a multidisciplinary pediatric intensive care unit]
Insights
Paediatric intensive care units (PICUs) serve children aged 1 week to 18 years. This study analyzed 4646 admissions, finding major trauma, intoxications, and postoperative congenital heart conditions were common, with a 5.8% mortality rate.
Area of Science:
- Pediatrics
- Intensive Care Medicine
- Health Services Research
Background:
- Paediatric intensive care units (PICUs) are relatively new compared to neonatal services.
- The patient population and common conditions treated in PICUs are not well-documented in medical literature.
Purpose of the Study:
- To define the clientele of a multidisciplinary paediatric intensive care unit.
- To analyze patient demographics, diagnoses, and outcomes in a PICU setting.
Main Methods:
- Retrospective analysis of 4646 consecutive admissions to a PICU.
- Data collected over a five-year period (1979-1983) for patients aged 1 week to 18 years.
- Inclusion of both medical and surgical tertiary care admissions.
Main Results:
- Surgical admissions (54.3%) outnumbered medical admissions (45.6%).
- Frequent diagnoses included major trauma (9.6%), intoxications (4.6%), and postoperative congenital cardiopathies (e.g., Tetralogy of Fallot, ASD).
- The overall mortality rate was 5.8%, with severe infections and cardiopathies accounting for nearly half of deaths.
Conclusions:
- This patient profile aids in planning PICU personnel training and resource allocation.
- Findings can inform the development of guidelines to reduce mortality in paediatric intensive care.
- Understanding PICU patient demographics is crucial for improving care and outcomes.
Abstract:
In contrast with neonatal intensive care services, paediatric intensive care units are relatively new; thus, it is not surprising that their clientele has not been well described in the medical literature. In order to better define it, we did a retrospective analysis of 4646 consecutive admissions of children aged between a week and 18 years to a multidisciplinary paediatric intensive care unit over a period of five years (1979-83). This unit belongs to a 700-bed paediatric hospital delivering medical as well as surgical tertiary care. Of the 4646 admissions, 2527 (54.3 per cent) were surgical and 2119 (45.6 per cent) medical. There were multiple diagnoses on admission. Among the most frequent diagnoses were major trauma (9.6 per cent of total), intoxications (4.6 per cent) and congenital cardiopathies in the postoperative phase of a corrective or palliative surgery (tetralogy of Fallot (2.8 per cent), ASD (2.7 per cent), etc.) The global mortality rate was 5.8 per cent (268/4646). Severe infections and cardiopathies, mostly congenital, were responsible for almost half the deaths (24.2 per cent each). This description of patients and problems encountered in a paediatric intensive care unit should facilitate planning for personnel training and can be used to establish guidelines for reducing mortality.