Abstract
The records of all admissions to a 6-bed pediatric intensive care unit (PICU) over a period of 6 years were reviewed. The age, diagnosis, clinical service provided, duration of stay and outcome were recorded. Of the 3025 children admitted, 2092 (69.2%) were males. Neonates constituted 13.1% (400) and infants 57.1% (1727) of total admissions. The duration of stay ranged from 6 hours to 46 days, and 61 patients stayed for longer than 13 days (long-stay patients). The most common cause for admission was septicemia, seen in 459 patients (14.8%); 418 (13.8%) children had congenital heart disease, 407 (13.5%) lower respiratory tract infections (LRTI) and 261 (8.6%) meningitis. The most common conditions necessitating long-stay in the PICU were meningitis (20%), Landry-Guillain-Barre syndrome (16.6%), acute renal failure (20%), and septicemia (16.6%). There were 721 deaths giving a mortality of 23.5%. Of these 134 (18.6%) were due to septicemia, 103 (14.2%) due to congential heart disease, 77 (10.6%) due to meningitis and 55 (7.6%) due to LRTI. The highest case fatality rate was seen with encephalitis (52.6%), followed by hepatic coma (51.3%), malignancies (43.2%), septicemia (29.1%) and meningitis (29.5%). The mortality was lower (9.8%) in long-stay patients than in short-stay patients (24.6%). There was gradual increase in proportion of cases requiring interventions including artificial ventilation (1% to 35%), peritoneal dialysis (1.5% to 11%), insertion of central venous pressure lines (0 to 10%), over the last 6 years. The comparison of case fatality rates before and after the PICU was made a functionally independent unit eleven months ago, reveals a declining trend for certain diseases including LGB syndrome (22.5% to 0%) (p<0.02), dengue hemorrhagic fever (44% to 9%) (p<0.02), meningitis (34% to 20%). renal failure (17% to 10%), encephalitis (55% to 26%). The ventilator survival increased from 22% to 42% (p<0.001).
Article PDF
Similar content being viewed by others
References
Committee on hospital care and pediatric section of the Society of Critical Care Medicine: Guidelines for Pediatric Intensive Care Units. Pediatrics 1983; 72: 364–371.
Pollock MM, Ruttimann UE, Glass NL and Yeh TS. Monitoring patients in pediatric intensive care.Pediatrics 1985; 76: 719–724.
Pollock MM, Ruttimann UE and Getson PR. Accurate prediction of the outcome of pdiatric intensive care.N Engl J Med 1987; 316: 134–139.
Mink BR, Pollock MM. Resuscitation and withdrawl of therapy in pediatric intensive care.Pediatrics 1992; 4: 393–395.
Pollock MM, Wilkinson JD and Glass NL. Long-stay pediatric intensive care unit patients: Outcome and resource utilization.Pediatrics 1987; 80: 855–860.
Detsky AS, Stricker SC, Mulley AG and Thibault GF. Prognosis, survival and the expenditure of hospital resources for patients in an ICU.N Engl J Med 1981; 305: 667–672.
Evans RW. Health care technology and the inevitability of resource allocation and rationing decisions.JAMA 1983; 249: 2208–2219.
Eisenberg JM and Williams SV. Physicians' responsibilities for the cost of unnecessary medical services.N Engl J Med 1978; 299: 76–80.
Relmann AS. Intensive care units. Who needs them?N Engl J Med 1980; 302: 965–966.
Hebel JR, Kessler H, Mabuchi K, and McCarter RJ. Assessment of hospital performance by use of death rates: A recent case history,JAMA 1982; 248: 3131–3135.
Thibault GE, Mulley AG, Barnett GO et al. Medical intensive care: indications, interventions and outcomes.N Engl J Med 1980; 302: 938–942.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kapil, D., Bagga, A. The profile and outcome of patients admitted to a pediatric intensive care unit. Indian J Pediatr 60, 5–10 (1993). https://doi.org/10.1007/BF02860496
Issue Date:
DOI: https://doi.org/10.1007/BF02860496