Factors present on admission associated with increased mortality in children admitted to a paediatric intensive care unit (PICU)

Hendricks, Candice; McKerrow, Neil; Hendricks, Randy

doi:10.7196/sajch.2016.v10i1.1048

Cited by 13 publications

(28 citation statements)

References 17 publications

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“…The demographic profile was consistent with previous PICU/pneumonia studies from Asian countries; where maximum admissions were from infant group and constituting males predominantly . Infants not only contributed to majority of admissions, but also had higher mortality than the rest, as in agreement with the previous reports …”

Section: Discussionsupporting

confidence: 91%

“…Our overall recorded mortality of 30% was higher than the reported PICU respiratory mortality of 7% to 25% in most other studies . Bronchopneumonia contributed to 91% of all respiratory mortality.…”

Section: Discussioncontrasting

confidence: 67%

“…11,[14][15][16][17][18] Infants not only contributed to majority of admissions, but also had higher mortality than the rest, as in agreement with the previous reports. 6,8,15,17,[19][20][21] Bronchopneumonia contributed to one-fourths of all PICU admissions and almost two-thirds of respiratory admissions; these values though comparable with few other studies, was much higher than the most. 5,6,14,[22][23][24] Diagnosis of bronchopneumonia itself has been associated with increased risk of mortality in many studies; the study by Pilar et al on ARI in PICU reported a 7.8 times increased risk of death by bronchopneumonia as compared with other diagnosis in ARI.…”

Section: Discussionsupporting

confidence: 64%

“…in their analysis of outcome in ICU based on PRISM score showed that with every increase in PRISM by 1, the child's odds of death increased by 36% . Almost one‐third of admitted patients in our study were incompletely immunized or malnourished; both factors proven to increase the risk of mortality . Immunization has been a major milestone in curbing diseases and an increased coverage of vaccine preventable disease needs to be reinforced.…”

Section: Discussionmentioning

confidence: 88%

“…Immunization has been a major milestone in curbing diseases and an increased coverage of vaccine preventable disease needs to be reinforced. Malnutrition persists to be a major public health issue in the developing world and extremes in weight have been demonstrated to have a significant impact on survival in PICU; children with weight below 3rd percentile having double the risk of mortality as compared to those at 75th percentile . Also, malnutrition is a predictor of mortality in acute lower respiratory tract infection (ALRTI) .…”

Section: Discussionmentioning

confidence: 99%

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Burden of respiratory illnesses in pediatric intensive care unit and predictors of mortality: Experience from a low resource country

Divecha¹,

Tullu²,

Chaudhary³

2019

Pediatric Pulmonology

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Introduction and Objectives Acute respiratory infections (ARI), a major cause of childhood mortality and morbidity, place substantial burden on health services worldwide. Due to scarce data regarding respiratory illnesses requiring Pediatric intensive care unit (PICU) admissions (especially in low income/developing countries), we studied the burden of respiratory illnesses in the PICU and the risk factors contributing to mortality. Methods This prospective observational study was conducted over 18 months. Children (aged 1 month to 12 years) admitted to the PICU for acute respiratory/cardiorespiratory illnesses were enrolled. Demographic and clinical details of the study population were recorded and tabulated. Risk factors contributing to mortality (severity of illness [PRISM III score], diagnosis/etiology, need for mechanical ventilation, immunocompromised status, malnutrition, and length of stay [LOS]) were analyzed (using the χ2 test or Fischer Exact test). Results Two hundred and ninety‐three children were enrolled (median age: 5 months; range, 1‐132 months; male/female: 181/112). Mean LOS in PICU was 5.25 ± 5.48 days and mean length of hospital stay of 14.82 ± 13.35 days. Mechanical ventilation was required in 62.8% cases. Pneumonia contributed to 66.89% of respiratory admissions and 91% of mortality. Ninety patients (30.7%) died; mortality being higher in cardiorespiratory cases (52.7%). PRISM III score and shock (respiratory cases) and age below 1 year (cardiorespiratory group) were significantly associated with higher mortality ( P < 0.05). Conclusions Respiratory illnesses are a significant contributor to PICU admissions and are associated with significant mortality risk in presence of high PRISM III score and shock (respiratory group); and age below 1 year (cardiorespiratory group).

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 67%

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Burden of respiratory illnesses in pediatric intensive care unit and predictors of mortality: Experience from a low resource country

Divecha¹,

Tullu²,

Chaudhary³

2019

Pediatric Pulmonology

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The essence, opportunities and threats to Advanced Practice Nursing in Sub-Saharan Africa: A scoping review

Christmals

Armstrong

2019

Heliyon

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BackgroundThe conditions that stimulated the implementation of Advanced Practice Nursing programmes all over the world have long been ignored in sub-Saharan Africa.ObjectiveThis study sought to explore the essence, opportunities and threats to the implementation of an Advanced Practice Nursing (Child Health Nurse Practitioner) programmes in sub-Saharan Africa.MethodsA scoping review was conducted and findings reviewed by a multinational multidisciplinary health experts’ team through a Delphi study.ResultsChildren are the majority of the 70–90% of the sub-Saharan African population who reside in the rural areas where access to timely, quality and cost-effective healthcare is poor. The Child Health Nurse Practitioner programme offers an opportunity to provide quality, timely and cost-effective healthcare to sub-Saharan Africa children. Limited resources, opposition from the medical profession, poor nursing governance and lack of context-specific Advanced Practice Nursing benchmark programmes constitute threats to the programme.ConclusionThe sub-Saharan Africa context provides opportunities that the nursing profession can harness to surmount such threats. Nursing governance structures, however, need to advocate for government and other stakeholders’ support for the Child Health Nursing Practitioner programme.

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Healthcare-associated infection in the Grey’s Hospital paediatric intensive care unit: does an Infection Control Programme work?

Armour

Patrick

Reddy

et al. 2018

Southern African Journal of Infectious Diseases

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Factors present on admission associated with increased mortality in children admitted to a paediatric intensive care unit (PICU)

Cited by 13 publications

References 17 publications

Burden of respiratory illnesses in pediatric intensive care unit and predictors of mortality: Experience from a low resource country

Burden of respiratory illnesses in pediatric intensive care unit and predictors of mortality: Experience from a low resource country

The essence, opportunities and threats to Advanced Practice Nursing in Sub-Saharan Africa: A scoping review

Healthcare-associated infection in the Grey’s Hospital paediatric intensive care unit: does an Infection Control Programme work?

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