Short-term and long-term mortality following pediatric intensive care

Pediatrics International, 04/26/2012

Volakli EA et al. – A 2 year follow–up period seems sufficient for a comprehensive mortality analysis of pediatric intensive care unit (PICU) patients. Severity of critical illness is the key factor of short–term mortality, whereas comorbidity is the major determinant of long–term mortality.

Methods

  • This was a prospective observational study. Data collected consisted of demographics, severity scores, procedures, treatment, need for and duration of mechanical ventilation (MV), length of PICU and hospital stay, and mortality at PICU and hospital discharge, at 3 and 6 months and at 1 and 2 years.

Results

  • A total of 300 patients (196 boys and 104 girls), aged 54.26 ± 49.93 months, were included in the study.
  • Median (interquartile range) Pediatric Risk of Mortality (PRISM III-24) score was 7 (3–11) and predicted mortality rate was 11.16%. MV rate was 67.3% (58.3% at admission) for 6.54 ± 14.15 days, and length of PICU and hospital stay was 8.85 ± 23.28 days and 20.69 ± 28.64 days, respectively.
  • Mortality rate at discharge was 9.7% and cumulative mortality rate thereafter was 12.7%, 15.0%, 16.7%, 19.0%, and 19.0% at hospital discharge, 3 months, 6 months, 1 year and 2 years, respectively.
  • Significant risk factors of PICU mortality were inotrope use, PRISM III-24 score >8, MV, arterial and central venous catheterization, nosocomial infection, complications, and cancer.

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