BinDahman Haifa Ali
Pediatric department, Hadhramaut University College of Medicine and Health science, Hadhramaut province, Mukalla city, Yemen.
J Epidemiol Glob Health. 2025 Jul 18;15(1):99. doi: 10.1007/s44197-025-00445-3.
The pediatric intensive care unit (PICU) plays a crucial role in managing critically ill children requiring advanced airway, respiratory, and hemodynamic support. Reducing the mortality rate is one of the primary objectives in every ICU. However, data regarding mortality and associated risk factors from low-resource countries remain insufficient. The aim of our study was to describe the mortality pattern, and to evaluate risk factors associated with mortality in the PICU at Mukalla Maternity and Childhood Hospital.
This retrospective study analyzed the admission records for children aged over 1 month to 15 years from the PICU over four years (1st January 2021 to 31st December 2024). The information retrieved included gender, age, place of residence, body weight, nutritional status, vaccination status, clinical presentations on admission, temperature, level of consciousness, presence of co-morbidities, the lag time between illness onset and hospital admission, date of admission, date of discharge, referring source, readmission frequency, diagnosis, need for mechanical ventilation, and condition at discharge (survived /deceased).
Out of the 790 patients admitted to the PICU, 716 were included in the study. The three most common disease categories among admissions were respiratory diseases (29.5%), central nervous system diseases (27.1%), and gastrointestinal diseases (11%). The overall mortality rate was 38.1%. Among deceased patients, 57.9% were severely undernourished, 38.5% were unvaccinated, and 63.4% had associated co-morbidities. The most common causes of death were pneumonia (26%), meningoencephalitis (17.2%), and sepsis/septic shock (9.2%). Independent risk factors of PICU mortality included length of PICU stay [AOR 0.129, p < 0.001], need for mechanical ventilation [AOR 68.6, p < 0.001], cardiovascular diseases [AOR 3.1, p = 0.003], hypothermia [AOR 7.1, p = 0.014], convulsions [AOR 0.375, p = 0.001], disturbance of consciousness [AOR 2.1, p = 0.002], and hepatosplenomegaly [AOR 15.7, p = 0.024].
The mortality in our PICU is high and is associated with several independent factors. Recognizing these risk factors will facilitate the identification of critical cases, enable the prioritization of resources, and support the implementation of essential modifications.
儿科重症监护病房（PICU）在管理需要高级气道、呼吸和血流动力学支持的危重症儿童方面发挥着关键作用。降低死亡率是每个重症监护病房的主要目标之一。然而，来自资源匮乏国家的死亡率及相关风险因素的数据仍然不足。我们研究的目的是描述死亡率模式，并评估穆卡拉妇幼医院PICU中与死亡率相关的风险因素。
这项回顾性研究分析了四年来（2021年1月1日至2024年12月31日）PICU中1个月以上至15岁儿童的入院记录。检索到的信息包括性别、年龄、居住地点、体重、营养状况、疫苗接种状况、入院时的临床表现、体温、意识水平、合并症情况、发病至入院的间隔时间、入院日期、出院日期、转诊来源、再入院频率、诊断、机械通气需求以及出院时的状况（存活/死亡）。
在790名入住PICU的患者中，716名被纳入研究。入院患者中最常见的三类疾病是呼吸系统疾病（29.5%）、中枢神经系统疾病（27.1%）和胃肠道疾病（11%）。总体死亡率为38.1%。在死亡患者中，57.9%严重营养不良，38.5%未接种疫苗，63.4%有合并症。最常见的死亡原因是肺炎（26%）、脑膜脑炎（17.2%）和败血症/感染性休克（9.2%）。PICU死亡率的独立风险因素包括PICU住院时间[AOR 0.129，p < 0.001]、机械通气需求[AOR 68.6，p < 0.001]、心血管疾病[AOR 3.1，p = 0.003]、体温过低[AOR 7.1，p = 0.014]、惊厥[AOR 0.375，p = 0.001]、意识障碍[AOR 2.1，p = 0.002]和肝脾肿大[AOR 15.7，p = 0.024]。
我们PICU的死亡率很高，且与多个独立因素相关。识别这些风险因素将有助于识别危重症病例，实现资源的优先分配，并支持实施必要的改进措施。
