Differences in pediatric ICU mortality risk over time

Tilford, John M.; Roberson, Paula K.; Lensing, Shelly; Fiser, Debra H.

doi:10.1097/00003246-199810000-00032

Cited by 66 publications

(39 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The application of these results to other pediatric ICUs, therefore, is open to question. In addition, the length of the study period may be questioned in view of changes in the nature of intensive care services over the 13-yr period (23). On the other hand, we were unable to demonstrate any significant change in the probability of survival during that period.…”

Section: Discussionmentioning

confidence: 68%

Outcome of severe sepsis in pediatric oncology patients*

Fiser

West

Bush

et al. 2005

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

In a large series of pediatric oncology patients with severe sepsis, ICU mortality was only 17% overall, although mortality remained quite high in the higher acuity patients. Mortality among the higher acuity patients was significantly associated with only a small number of variables. The number of patients alive at 6 months and the encouraging ICU survival rate further justifies the use of aggressive ICU interventions in this population.

show abstract

Section: Discussionmentioning

confidence: 68%

Outcome of severe sepsis in pediatric oncology patients*

Fiser

West

Bush

et al. 2005

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Advances in paediatric critical care have led to a reduction in mortality and most children are now expected to make a complete physical recovery (1,2). Indeed, from 2008 to 2010 over 52,000 children aged 0-15 years old were admitted to PICUs in the UK and Ireland, with over 95% leaving alive (3).…”

Section: Introductionmentioning

confidence: 99%

Neuropsychologic Function Three to Six Months Following Admission to the PICU With Meningoencephalitis, Sepsis, and Other Disorders

Als

Nadel

Cooper

et al. 2013

Critical Care Medicine

View full text Add to dashboard Cite

Objective: To assess short-term neuropsychological function and academic performance in school children following admission to intensive care and to explore the role of critical neurological and systemic infection.Design: A prospective observational case-control study.Setting: Two Paediatric Intensive Care Units (PICUs).Subjects: A consecutive sample of 88 children aged 5-16 years (Mdn age = 10.00, IQR = 6.00-13.00) admitted to PICU between 2007 and 2010 with meningo-encephalitis, septic illness, or other critical illnesses were assessed three to six months following discharge and performance compared with 100 healthy controls. Patients were without prior neurological or neuro-developmental disorder.Interventions: None.Measurements and Main Results: Data encompassing demographic and critical illness details were obtained and children were assessed using tests of intellectual function, memory, and attention. Questionnaires addressing academic performance were returned by teachers. After adjusting for co-variates, the PICU admitted children significantly underperformed on neuropsychological measures in comparison to the healthy controls (ps<.02). Teachers deemed more PICU children than controls as performing educationally worse and having problems with school work (ps=.001), as well as performing below average on aspects of executive function and attention (ps<.04). Analysis of the effect of illness type on outcome revealed that aspects of 3 neuropsychological function, such as memory function, and teacher-rated academic performance were most reduced in children with meningo-encephalitis and septic illness. In the PICU group, multivariable linear regression revealed that worse performance on a composite score of neuropsychological impairment was more prevalent when children were younger, from a lower social class, and had experienced seizures during their admission (ps<.02).Conclusions: Admission to PICU is followed by deficits in neuropsychological performance and educational difficulties, with more severe difficulties noted following meningo-encephalitis and septic illness. These results highlight the importance of future studies on cognition and educational outcome incorporating type of illness as a moderating factor.

show abstract

“…The development of specialised paediatric intensive care units (ICUs) has contributed to the improved survival of critically ill children [1], however, the long-term (beyond 1 year after admission to the ICU) functional outcome and quality of survival of these children is often unknown. In an era which focuses upon rationalisation and optimisation of health care resources, evaluation of patient outcome is fundamental in evaluating the effectiveness of intensive care [2,3].…”

Section: Introductionmentioning

confidence: 99%