Morbidity Pattern and Outcome of Patients Admitted into a Pediatric Intensive Care Unit in India

Abstract

BACKGROUND: Intensive care has become very important in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports and are usually admitted into the pediatric intensive care unit (PICU) with the aim of achieving an outcome better than if the patients were admitted into other parts of the hospital. It becomes important to audit admissions and their outcome, which may help to modify practices if necessary following thorough introspection, leading to better patient outcomes. OBJECTIVE: To evaluate the morbidity pattern and outcome of admissions into the PICU of a tertiary care center in India. METHODS: A retrospective study in which records of admissions (from August 2012 to June 2013) were obtained from the PICU records. Information retrieved included age, sex, diagnosis, duration of stay in the unit, and outcome. RESULTS: Mean age of the studied 341 patients was 40.01 ± 45.79 months; 50.7% were infants and 59.8% were males. The three most common disease categories admitted were cardiovascular disease (41.1%), neurological disorders (12.0%), and respiratory disease (10.0%). The mean duration of stay in PICU was 3.2 ± 4.5 days. The overall mortality rate was 2.1%. CONCLUSION: Mortality is low in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care greatly facilitates the care of critically ill patients giving desirable outcome. An expansion of the pediatric wards is advocated to enhance cost-effective management of patients and avoid unnecessary stretch of the PICU facilities.

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

“…The average LOS in PICU of 5.25 days was similar to several previous reports . Though studies report increased mortality with longer stays in the PICU; ours, like a few others, showed no such relationship . One study described a 2% increase in risk of death with every additional day of hospitalization .…”

“…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.…”

“…This high proportion is comparable with studies from Cairo (49.6%) and Hong Kong (39.6%), however, it is much higher than the 10% to 20% reported from PICUs in India. [7][8][9][10][11][12] This regional difference in etiological distribution of admissions could be due to variations in the disease profile, disease severity, and epidemiology which govern PICU admissions. Respiratory illnesses are a common cause of morbidity in cardiovascular diseases, but since most studies classify them separately, our respiratory admissions (inclusive of cardiorespiratory cases) may seem higher.…”

“…18,22,26,27 Though studies report increased mortality with longer stays in the PICU; ours, like a few others, showed no such relationship. 10,25,[28][29][30] One study described a 2% increase in risk of death with every additional day of hospitalization. 29 Death thus utilizes additional resources in terms of bed stay and diagnostic procedures than survivors; indicating a need to optimize healthcare resources, especially in a resource-limited setting like ours.…”

Morbidity pattern and outcome of patients admitted in a coronary care unit: a report from a secondary hospital in southern region, Saudi Arabia

“…The care of critically ill patients is undoubtedly one of the most burdensome and onerous aspects of intensive care medicine. Because intensive care and coronary care attract a huge cost on the part of the health facilities and patients care givers, it is usually only offered to patients whose condition is potentially reversible and who have a good chance of surviving with the intensive care support [2] Like in other parts of the world [3], the demographics of Saudi Arabia population is progressively changing; so does the mortality recorded from heart-related disorders, resulting in increased admission of middle-aged individuals and elderly with complicated cardiac diseases. The rapid socioeconomic growth in the Gulf countries, which engendered a tremendous shift in lifestyle such as an increased consumption of low quality cholesterol-laden foods and adoption of a sedentary lifestyle [4], has resulted in increase rates of CVD and associated risk factors among the Gulf population [4].…”