Department of Pediatrics, Seth G. S. Medical College & KEM Hospital, Mumbai, Maharashtra, India.
Pediatr Pulmonol. 2019 Aug;54(8):1234-1241. doi: 10.1002/ppul.24351. Epub 2019 May 14.
Acute respiratory infections (ARI), a major cause of childhood mortality and morbidity, place substantial burden on health services worldwide. Due to scarce data regarding respiratory illnesses requiring Pediatric intensive care unit (PICU) admissions (especially in low income/developing countries), we studied the burden of respiratory illnesses in the PICU and the risk factors contributing to mortality.
This prospective observational study was conducted over 18 months. Children (aged 1 month to 12 years) admitted to the PICU for acute respiratory/cardiorespiratory illnesses were enrolled. Demographic and clinical details of the study population were recorded and tabulated. Risk factors contributing to mortality (severity of illness [PRISM III score], diagnosis/etiology, need for mechanical ventilation, immunocompromised status, malnutrition, and length of stay [LOS]) were analyzed (using the χ test or Fischer Exact test).
Two hundred and ninety-three children were enrolled (median age: 5 months; range, 1-132 months; male/female: 181/112). Mean LOS in PICU was 5.25 ± 5.48 days and mean length of hospital stay of 14.82 ± 13.35 days. Mechanical ventilation was required in 62.8% cases. Pneumonia contributed to 66.89% of respiratory admissions and 91% of mortality. Ninety patients (30.7%) died; mortality being higher in cardiorespiratory cases (52.7%). PRISM III score and shock (respiratory cases) and age below 1 year (cardiorespiratory group) were significantly associated with higher mortality ( P < 0.05).
Respiratory illnesses are a significant contributor to PICU admissions and are associated with significant mortality risk in presence of high PRISM III score and shock (respiratory group); and age below 1 year (cardiorespiratory group).
急性呼吸道感染（ARI）是儿童死亡和发病的主要原因，给全球卫生服务带来了巨大负担。由于关于需要儿科重症监护病房（PICU）收治的呼吸疾病的数据稀缺（尤其是在低收入/发展中国家），我们研究了 PICU 中呼吸疾病的负担以及导致死亡的危险因素。
这是一项为期 18 个月的前瞻性观察研究。患有急性呼吸道/心肺呼吸疾病并被收入 PICU 的儿童（年龄 1 个月至 12 岁）被纳入研究。记录并列表记录研究人群的人口统计学和临床详细信息。分析导致死亡的危险因素（疾病严重程度[PRISM III 评分]、诊断/病因、机械通气需求、免疫功能低下状态、营养不良和住院时间[LOS]）（使用 χ 检验或 Fischer 精确检验）。
共纳入 293 名儿童（中位数年龄：5 个月；范围，1-132 个月；男/女：181/112）。PICU 的平均 LOS 为 5.25±5.48 天，平均住院时间为 14.82±13.35 天。62.8%的病例需要机械通气。肺炎导致 66.89%的呼吸道疾病入院，91%的死亡。90 例（30.7%）死亡；心肺病例的死亡率更高（52.7%）。PRISM III 评分和休克（呼吸病例）以及年龄低于 1 岁（心肺组）与更高的死亡率显著相关（P<0.05）。
呼吸疾病是 PICU 收治的主要原因，在存在高 PRISM III 评分和休克（呼吸组）以及年龄低于 1 岁（心肺组）的情况下，与较高的死亡风险相关。
