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The profile and outcome of patients admitted to a pediatric intensive care unit
Insights
This study analyzed 3025 pediatric intensive care unit admissions over six years. Septicemia and congenital heart disease were leading causes of admission and mortality, with lower mortality observed in long-stay patients.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Epidemiology
Background:
- Pediatric intensive care units (PICUs) manage critically ill children.
- Understanding admission patterns, diagnoses, and outcomes is crucial for resource allocation and quality improvement.
Purpose of the Study:
- To analyze the characteristics of admissions to a pediatric intensive care unit.
- To identify common diagnoses, outcomes, and factors influencing mortality.
- To assess trends in interventions over a six-year period.
Main Methods:
- Retrospective review of all admissions to a 6-bed PICU over six years.
- Data collected included age, diagnosis, clinical service, duration of stay, and outcome.
- Statistical analysis of demographic, diagnostic, and outcome data.
Main Results:
- 3025 children admitted; 69.2% males. Neonates and infants comprised 13.1% and 57.1% respectively.
- Leading diagnoses: septicemia (14.8%), congenital heart disease (13.8%), lower respiratory tract infections (LRTI) (13.5%), and meningitis (8.6%).
- Overall mortality was 23.5%. Long-stay patients had lower mortality (9.8%) than short-stay patients (24.6%). Interventions like artificial ventilation increased significantly.
Conclusions:
- Septicemia and congenital heart disease are major drivers of PICU admissions and mortality.
- While long-stay patients had better outcomes, the increasing need for interventions highlights evolving critical care demands.
- Continuous monitoring and adaptation of PICU services are essential.
Abstract:
The records of all admissions to a 6-bed pediatric intensive care unit (PICU) over a period of 6 years were reviewed. The age, diagnosis, clinical service provided, duration of stay and outcome were recorded. Of the 3025 children admitted, 2092 (69.2%) were males. Neonates constituted 13.1% (400) and infants 57.1% (1727) of total admissions. The duration of stay ranged from 6 hours to 46 days, and 61 patients stayed for longer than 13 days (long-stay patients). The most common cause for admission was septicemia, seen in 459 patients (14.8%); 418 (13.8%) children had congenital heart disease, 407 (13.5%) lower respiratory tract infections (LRTI) and 261 (8.6%) meningitis. The most common conditions necessitating long-stay in the PICU were meningitis (20%), Landry-Guillain-Barre syndrome (16.6%), acute renal failure (20%), and septicemia (16.6%). There were 721 deaths giving a mortality of 23.5%. Of these 134 (18.6%) were due to septicemia, 103 (14.2%) due to congenital heart disease, 77 (10.6%) due to meningitis and 55 (7.6%) due to LRTI. The highest case fatality rate was seen with encephalitis (52.6%), followed by hepatic coma (51.3%), malignancies (43.2%), septicemia (29.1%) and meningitis (29.5%). The mortality was lower (9.8%) in long-stay patients than in short-stay patients (24.6%). There was gradual increase in proportion of cases requiring interventions including artificial ventilation (1% to 35%), peritoneal dialysis (1.5% to 11%), insertion of central venous pressure lines (0 to 10%), over the last 6 years.(ABSTRACT TRUNCATED AT 250 WORDS)