Martinot A, Grandbastien B, Leteurtre S, Duhamel A, Leclerc F
Paediatric Intensive Care Unit, CERIM, CH et U Lille, France.
Acta Paediatr. 1998 Jul;87(7):769-73. doi: 10.1080/080352598750013860.
To determine the incidence of different modes of death in French paediatric intensive care units and to compare patients' characteristics, including a severity of illness score (Paediatric Risk of Mortality: PRISM score) and prior health status (Paediatric Overall Performance Category scale), according to the mode of death.
A 4-month prospective cohort study.
Nine French multidisciplinary paediatric intensive care units.
All patients who died in PICUs, except premature babies.
Among 712 admissions, 13% patients died. Brain death was declared in 20%, failure of cardiopulmonary resuscitation occurred in 26%, do-not-resuscitate status was identified in 27%, and withdrawal of supportive therapy was noted in 27%. The PRISM score and the baseline Paediatric Overall Performance Category were not different between the four groups. Brain-dead patients were older than those in whom a do-not-resuscitate order and withdrawal of therapy were made (median age 81 vs 7 and 4 months).
Decisions to limit or to withdraw supportive care were made for a majority of patients dying in French paediatric intensive care units. Chronic health evaluation and severity of illness index are not sufficient to describe dead-patient populations.
确定法国儿科重症监护病房不同死亡模式的发生率，并根据死亡模式比较患者特征，包括疾病严重程度评分（儿科死亡风险：PRISM评分）和先前健康状况（儿科总体表现分类量表）。
一项为期4个月的前瞻性队列研究。
法国9个多学科儿科重症监护病房。
所有在儿科重症监护病房死亡的患者，早产儿除外。
在712例入院患者中，13%的患者死亡。20%的患者被宣布脑死亡，26%的患者心肺复苏失败，27%的患者被确定为不进行心肺复苏状态，27%的患者出现支持治疗的撤除。四组之间的PRISM评分和基线儿科总体表现分类无差异。脑死亡患者比下达不进行心肺复苏医嘱和撤除治疗的患者年龄大（中位年龄81岁对7个月和4个月）。
对于在法国儿科重症监护病房死亡的大多数患者，做出了限制或撤除支持治疗的决定。慢性健康评估和疾病严重程度指数不足以描述死亡患者群体。
