Cause of Death of Infants and Children in the Intensive Care Unit: Parents Recall vs Chart Review

Abstract

Background More than 55 000 children die annually in the United States, most in neonatal and pediatric intensive care units. Because of the stress and emotional turmoil of the deaths, the children’s parents have difficulty comprehending information. Objectives To compare parents’ reports and hospital chart data on cause of death and examine agreement on cause of death according to parents’ sex, race, participation in end-of-life decisions, and discussion with physicians; deceased child’s age; unit of care (neonatal or pediatric); and hospital and intensive care unit lengths of stay. Methods A descriptive, correlational design was used with a structured interview of parents 1 month after the death and review of hospital chart data. Parents whose children died in intensive care were recruited from 4 South Florida hospitals and from Florida Department of Health death records. Results Among 230 parents, 54% of mothers and 40% of fathers agreed with the chart cause of death. Agreement did not differ significantly for mothers or fathers by race/ ethnicity, participation in end-of-life decisions, discussions with physicians, or mean length of hospital stay. Agreement was better for mothers when the stay in the intensive care unit was the shortest. Fathers’ agreement with chart data was best when the deceased was an infant and death was in the pediatric intensive care unit. Conclusions Death of a child is a time of high stress when parents’ concentration, hearing, and information processing are diminished. Many parents have misconceptions about the cause of the death 1 month after the death.

Early identification of impending cardiac arrest in neonates and infants in the cardiovascular ICU: a statistical modelling approach using physiologic monitoring data

“…1 CHD and chromosomal abnormalities account for approximately 20% of sudden deaths among neonates and infants (≤1 year old) and for nearly 5% among older children (1-18 years of age). 2 Epidemiologic studies have also indicated that cardiac arrest is associated with lower survival rates in neonates and infants than in children and adolescents, with rates of survival to hospital discharge less than 15% in several studies. [3][4][5][6] Cases of in-hospital arrest have a three-fold higher chance of survival than out-of-hospital cases (24 versus 8.4%).…”

Gambaran Mortalitas Pasien Di Ruang Picu Rsud Abdul Wahab Sjahranie Samarinda Periode 2016-2017

“…Penelitian di Hospital Israelita Albert Einstein Brazil menunjukkan jumlah pasien yang masuk ruang PICU rata-rata 69,3% per tahun dan jumlah pasien terbanyak berada pada bulan April, Agustus, dan Oktober. Rata-rata lama tinggal di rumah sakit berkisar antara 9 sampai 19 hari (Brooten et al, 2016). Kelompok usia terbanyak yang masuk ruang PICU adalah usia 1 sampai 4 tahun (Brooten et al, 2016).…”

“…Rata-rata lama tinggal di rumah sakit berkisar antara 9 sampai 19 hari (Brooten et al, 2016). Kelompok usia terbanyak yang masuk ruang PICU adalah usia 1 sampai 4 tahun (Brooten et al, 2016). Sekitar 55% dari semua anak yang meninggal di ruang PICU adalah laki-laki, usia ratarata adalah 2 tahun dan sepertiga berusia kurang dari satu tahun (Burns et al, 2014).…”

“…Penelitian di Inggris melaporkan pasien yang dirawat di ruang PICU terbanyak menderita penyakit kardiovaskular diikuti oleh penyakit pernapasan dan neurologis. Akan tetapi, penyakit pernapasan adalah penyebab tersering untuk perawatan di ruang PICU (Brooten et al , 2016). Di Indonesia penyakit terbanyak yang di rawat di ruang PICU adalah diare, pneumonia, enterokolitis, meningitis, penyakit jantung bawaan, status epileptikus, demam berdarah, campak, tenggelam, malaria, leukemia dan lain lain (Djajakusli dkk, 2017).…”

“…Sekitar 70% pasien meninggal setelah pemotongan tali pusar atau penarikan perawatan penunjang hidup, 16% didiagnosis mati batang otak dan 14% meninggal setelah usaha resusitasi yang tidak berhasil (Burns et al, 2014). Gagal napas adalah penyakit yang paling banyak pada pasien yang dirawat di ruang PICU dan tingkat kematian tertinggi dikaitkan dengan penyakit neoplastik ( (Brooten et al, 2016). Diare merupakan penyebab kematian terbanyak di ruang PICU, sedangkan pneumonia merupakan penyakit penyebab kematian tertinggi kedua setelah diare diantara balita.…”