Hajidavalu Fatemeh S, Sadeghizadeh Atefeh
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatric, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2023 Apr 25;12:92. doi: 10.4103/abr.abr_371_21. eCollection 2023.
Various studies have conducted to report the mortality rates and its risk factors in pediatric intensive care unit. This study aimed to determine the mortality prevalence and risk factors in PICU of Imam Hossein Children's Hospital in Isfahan, which is the main referral pediatric hospital in the center of Iran.
This study was performed on 311 patients during a period of 9 months. The questionnaire which included age, gender, length of stay in the PICU and hospital, mortality, history of resuscitation in other wards and readmission, the causes and sources of hospitalization, pediatric risk of mortality (PRISM)-III score, respiratory supports, morbidities like nosocomial infections, acute kidney injury (AKI), multiple organ dysfunction syndrome (MODS) confirmed by pediatric sequential organ failure assessment score (P-SOFA) and glycemic disorders was filled out.
One hundred and seventy-seven (56.9%) were males and 103 (33%) were belonged to the age group of 12-59 months. The most prevalent causes of hospitalization were status epilepticus (12.9%) and pneumonia (11.2%). Mortality rate was 12.2%. The significant factors associated with mortality were readmission and history of resuscitation. PRISM-III index showed a significant difference between nonsurvivors and survivors (7.05 ± 6.36 vs. 3.36 ± 4.34, = 0.001). Complications like AKI, hypoglycemia, MODS and disseminated intravascular coagulation (DIC), length of mechanical ventilation significantly correlated with mortality.
Mortality rate was less than that of other developing countries (12.2%) and this was associated with some risk factors included readmission, history of resuscitation, PRISM-III Index; complications like AKI, acute respiratory distress syndrome (ARDS), DIC, mechanical ventilation duration, MODS, hypoglycemia, and P-SOFA index.
已经开展了多项研究来报告儿科重症监护病房的死亡率及其危险因素。本研究旨在确定伊朗中部主要的转诊儿科医院——伊斯法罕伊玛目侯赛因儿童医院儿科重症监护病房的死亡率及危险因素。
本研究对9个月期间的311例患者进行。填写了包含年龄、性别、在儿科重症监护病房和医院的住院时间、死亡率、在其他病房的复苏史和再次入院情况、住院原因和来源、儿科死亡风险(PRISM)-III评分、呼吸支持、医院感染、急性肾损伤(AKI)、通过儿科序贯器官衰竭评估评分(P-SOFA)确认的多器官功能障碍综合征(MODS)以及血糖紊乱等内容的问卷。
177例(56.9%)为男性,103例(%)属于12至59个月年龄组。最常见的住院原因是癫痫持续状态(12.9%)和肺炎(11.2%)。死亡率为12.2%。与死亡率相关的显著因素是再次入院和复苏史。PRISM-III指数在非幸存者和幸存者之间显示出显著差异(7.05±6.36对3.36±4.34,P = 0.001)。AKI、低血糖、MODS和弥散性血管内凝血(DIC)等并发症、机械通气时间与死亡率显著相关。
死亡率低于其他发展中国家(12.2%),这与一些危险因素有关,包括再次入院、复苏史、PRISM-III指数;AKI、急性呼吸窘迫综合征(ARDS)、DIC、机械通气持续时间、MODS、低血糖和P-SOFA指数等并发症。