Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands

SKIC Dutch Collaborative PICU Res, Carin W. Verlaat*, Nina Wubben, Idse H. Visser, Jan A. Hazelzet, Johannes Van der Hoeven, Joris Lemson, Mark van den Boogaard

*Corresponding author for this work

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Abstract

Background High-risk patients in the pediatric intensive care unit (PICU) contribute substantially to PICU-mortality. Complex chronic conditions (CCCs) are associated with death. However, it is unknown whether CCCs also increase mortality in the high-risk PICU-patient. The objective of this study is to determine if CCCs or other factors are associated with mortality in this group. Methods Retrospective cohort study from a national PICU-database (2006-2012, n = 30,778). High-risk PICU-patients, defined as patients <18 years with a predicted mortality risk > 30% according to either the recalibrated Pediatric Risk of Mortality-II (PRISM) or the Paediatric Index of Mortality 2 (PIM2), were included. Patients with a cardiac arrest before PICU-admission were excluded. Results In total, 492 high-risk PICU patients with mean predicted risk of 24.8% (SD 22.8%) according to recalibrated PIM2 and 40.0% (SD 23.8%) according to recalibrated PRISM were included of which 39.6% died. No association was found between CCCs and non-survival (odds ratio 0.99; 95% CI 0.62-1.59). Higher Glasgow coma scale at PICU admission was associated with lower mortality (odds ratio 0.91; 95% CI 0.87-0.96). Conclusions Complex chronic conditions are not associated with mortality in high-risk PICU patients.

Original languageEnglish
Article number274
Number of pages6
JournalBMC Pediatrics
Volume19
Issue number1
DOIs
Publication statusPublished - 6-Aug-2019

Keywords

  • Child
  • Critical care
  • Mortality
  • Outcome assessment (healthcare)
  • HOSPITAL CARDIAC-ARREST
  • INTENSIVE-CARE
  • CHILDREN
  • IMPACT
  • INDEX

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