Abstract
BackgroundAssessement of the pattern of admission and treatment outcomes of critically ill pediatrics admitted to pediatric intensive care units (PICU) in developing countries is crucial. In these countries with resource limitations, it may help to identify priorities for resource mobilization that may improve patient service quality. The PICU mortality rate varies globally, depending on the facilities of the intensive care unit, availability of experties, and admission patterns. This study assessed the admission pattern, treatment outcomes, and associated factors for children admitted to the PICU.MethodsA retrospective cross-sectional study was implemented on 406 randomly selected pediatrics patients admitted to the PICU of Tikur Anbessa Specialized Hospital from 1-Oct-2018 to 30-Sept-2020. The data were collected with a pretested questionnaire. A normality curve was used to check for data the distribution. Both bivariable and multivariable analyses were used to see association of variables. A variable with a p-value of < 0.2 in the bivariable model was a candidate for multivariate analysis. The strength of association was shown by an adjusted odds ratio (AOR) with a 95% Confidence interval (CI), and a p-value of < 0.05 was considered statistically significant. Frequency, percentage,and tables were used to present the data.ResultsA total of 361 (89% response rate) patient charts were studied, 197 (54.6%) were male, and 164(45.4%) were female. The most common pattern for admission was a septic shock (27.14%), whereas the least common pattern was Asthma 9(2.50%). The mortality rate at the pediatric intensive care unit was 43.8%. Moreover, mechanical ventilation need (AOR = 11.2, 95%CI (4.3–28.9), P < 0.001), need for inotropic agents (AOR = 10.7, 95%CI (4.1–27.8), P < 0.001), comorbidity (AOR =8.4, 95%CI (3.5–20.5), P < 0.001), length of PICU stay from 2 to 7 days (AOR = 7.3, 95%CI (1.7–30.6), P = 0.007) and severe GCS (< 8) (AOR = 10.5, 95%CI (3.8–29.1), P < 0.001) were independent clinical outcome predictors (mortality).ConclusionThe mortality rate at the PICU was 43.8%. Septic shock, and meningitis were the common cause of death and the largest death has happened in less than 7 days of admission.
Highlights
A pediatric intensive care unit (PICU) is a unit in a hospital where most critical children with life-threatening conditions receive pediatric care [1]
Socio‐demographic and clinical characteristics of admitted pediatrics A total of 406 patient charts were available for data collection, and 361 had full information required, this makes it 89% response rate, which is acceptable since we added a 10% attrition rate
Pediatric ward took the highest source of PICU admission 131(36.3%) followed by emergency pediatric unit 105(29.1%), operation room 90(24.9%), surgical ward 18(5%), and recovery room 17(4.7%)
Summary
A pediatric intensive care unit (PICU) is a unit in a hospital where most critical children with life-threatening conditions receive pediatric care [1]. Admission to intensive care unit (ICU) may be required if the patient experiences hemodynamic instability requiring frequent monitoring of vital signs, invasive hemodynamic monitoring, rapid titration of intravenous medication with concurrent monitoring, and respiratory support in the ICU. This may significantly improve the quality of care and outcomes of critically ill and injured patients, predominantly in high-resource settings [2]. Assessement of the pattern of admission and treatment outcomes of critically ill pediatrics admitted to pediatric intensive care units (PICU) in developing countries is crucial In these countries with resource limitations, it may help to identify priorities for resource mobilization that may improve patient service quality. This study assessed the admission pattern, treatment outcomes, and associated factors for children admitted to the PICU
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