Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: a prospective observational cohort study

Teshager, Nahom Worku; Amare, Ashenafi Tazebew; Tamirat, Koku Sisay

doi:10.1136/bmjopen-2019-036746

Cited by 19 publications

(38 citation statements)

References 22 publications

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“…In the current study, the analysis showed that majority 175 (57.4%) of children admitted to the PICU were males and under 5 years of age contributing more than half of the admission. This finding is comparable with a study done in Ethiopia and elsewhere [11][12][13][14] . And majority of patients were found in the age group of 10-14 years which is similar with a study done in Ethiopia [5] .…”

Section: Discussionsupporting

confidence: 91%

Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study

Ahmed¹

2022

International Journal of Surgery: Global Health

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Background: Intensive care unit is special unit primarily concerned with the care of patients with critical illness. Caring of critically ill children remains one of the most demanding and challenging aspects of the field of pediatrics. Methods: A retrospective study design was conducted. All children from 1 month to 14 years of age who were admitted to the pediatric intensive care unit from September 2017 to September 2018 were included. Descriptive statistics was used to describe different characters. Results: A total of 305 children were admitted over the study period. Most of patients were males (57.4%) with a male-to-female ratio of 1.3:1. The overall mortality rate was 23.6%. The majority of the children were in the age range of 10-14 years (27.9%). Out of all patients, 23.6% were neurological cases and from these, 22.2% of patients were died. The highest percentages (12.8%) of neurological patients were admitted because of meningitis. Respiratory (19%) and cardiac (11.8%) cases were the second and the third causes of admission, respectively. Conclusion:The leading cause of admission and death was neurological causes. Respiratory and cardiac causes were also significant. The mortality rate was very high. Further interventions are recommended to reduce mortality and increase quality of care.

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Section: Discussionsupporting

confidence: 91%

Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study

Ahmed¹

2022

International Journal of Surgery: Global Health

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“…In this study, patients who were receiving mechanical ventilation had a threefold higher risk of passing away than those who were not. According to a research conducted in Gondar, Ethiopia, patients who require MV have a death rate that is 2.36 times greater than those who do not, 32 and this result is in line with that finding. In a similar vein, an Italian study indicated that patients who did not require MV had a better likelihood of surviving after being admitted to the PICU (100% vs 26.1%, P 0.001).…”

Section: Discussionsupporting

confidence: 72%

Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study

Dendir¹,

Awoke²,

Alemu³

et al. 2023

PHMT

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Background Critical care is a multidisciplinary and interprofessional specialty devoted to treating patients who already have or are at danger of developing acute, life-threatening organ dysfunction. Due to the higher disease load and mortality from preventable illness, patient outcomes in intensive care units are challenging in settings with inadequate resources. This study aimed to determine factors associated with outcomes of pediatric patients admitted to intensive care units. Methods A cross-sectional study was conducted at Wolaita Sodo and Hawassa University teaching hospitals in southern Ethiopia. Data were entered and analyzed using SPSS version 25. Normality tests using the Shapiro–Wilk and Kolmogorov–Smirnov data were normally distributed. The frequency, percentage, and cross-tabulation of the different variables were then determined. Finally, the magnitude and associated factors were first analyzed using binary logistic regression and then multivariate logistic regression. Statistical significance was set at P < 0.05. Results A total of 396 Pediatric ICU patients were included in this study, and 165 (41.7%) deaths were recorded. The odds of patients from urban areas (AOR = 45%, CI 95%: 8%, 67% p-value = 0.025) were less likely to die than those in rural areas. Patients with co morbidities (AOR = 9.4, CI 95%: 4.5, 19.7, p = 0.000) were more likely to die than pediatric patients with no co-morbidities. Patients admitted with Acute respiratory distress syndrome (AOR = 12.86, CI 95%: 4.3, 39.2, p = 0.000) were more likely to die than those with not. Pediatric patients on mechanical ventilation (AOR = 3, CI 95%: 1.7, 5.9, p = 0.000) more likely to die than not mechanically ventilated. Conclusion Mortality of paediatric ICU patients was high (40.7%) in this study. Co-morbid disease, residency, the use of inotropes, and the length of ICU stay were all statistically significant predictors of death.

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“…But we found significantly low mortality in studies with larger sample size when compared with studies of smaller sample size. Mortality in PICU varies from 2 to 30% across countries based on availability of resources and common diseases leading to ICU admissions [ 41 – 44 ]. The present analysis also showed that mortality among MIS-C patients increases by 4.68 times if the patients develop AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury following multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: a systematic review and meta-analysis

et al. 2022

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Introduction Multisystem inflammatory syndrome (MIS-C) is a rare paediatric hyper-inflammatory disorder that occurs following SARS-CoV-2 infection. Acute kidney injury (AKI) occurs in approximately one-quarter to one-third of the patients with MIS-C and is associated with poor prognosis in critically ill children. This systematic review is aimed to evaluate the incidence of AKI, mortality, and the need for kidney replacement therapy (KRT) in patients with MIS-C. Methods We searched databases from Medline, EMBASE, Cochrane Register, and Google Scholar from December 2019 to December 2021 with our search strategy. Studies meeting the following criteria were included in this systematic review: (1) articles on AKI in MIS-C; (2) studies providing AKI in MIS-C and COVID-19 infection separately; (3) studies reporting outcomes such as mortality, KRT, serum creatinine; length of hospital/ICU stay. Quality assessment The quality of the included studies was independently assessed by using the National Heart Lung and Blood Institute (NHLBI) quality assessment tool for cohort studies and case series. Statistical analysis Outcomes and their 95% confidence intervals (CI) were reported if a meta-analysis of these outcomes was conducted. Heterogeneity was reported using I 2 statistics, and heterogeneity ≥ 50% was considered high. We used Baujat’s plot for the contribution of each study toward overall heterogeneity. In sensitivity analysis, the summary estimates were assessed by repeating meta-analysis after omitting one study at a time. Forest plots were used for reporting outcomes in each study and with their 95% CI. All statistical tests were performed using R software version 4.0.3. Results A total of 24 studies were included in this systematic review and of these, 11 were included in the meta-analysis. The pooled proportion of patients with MIS-C developing AKI was 20% (95% CI: 14–28%, I 2 = 80%). Pooled proportion of death in children with MIS-C was 4% (95% CI: 1–14%; I 2 = 93%). The odds of death in patients with AKI were 4.68 times higher than in patients without AKI (95% CI: 1.06–20.7%; I 2 = 17%). The overall pooled proportion of MIS-C-induced AKI patients requiring KRT was 15% (95% CI: 4–42%; I 2 = 91%). Conclusion Approximately one-fifth of children with MIS-C develop AKI which is associated with higher odds of death. PROSPERO registration: CRD42022306170 Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Supplementary Information The online version contains supplementary material available at 10.1007/s00467-...

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Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: a prospective observational cohort study

Cited by 19 publications

References 22 publications

Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study

Admission patterns and outcome in a pediatric intensive care unit of the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a retrospective study

Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study

Acute kidney injury following multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: a systematic review and meta-analysis

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