P0270 / #681: PICUS ARE NOT SMALL ICUS

Abstract

Aims & Objectives: Kijabe Hospital (KH) opened its standalone PICU in August 2017. Prior to this date, like many hospitals in resource limited settings, patients were admitted to a combined ICU with adult patients and adult-trained staff. This study aimed to assess whether a dedicated PICU, with pediatric-trained nurses and clinical officers, had an impact on patient outcome. Methods: During this retrospective study, charts were reviewed for all patients, aged 16 years or less, admitted to the KH ICUs during two distinct time periods: combined ICU January 2014- July 2017, standalone PICU August 2017-December 2019. Age, gender, primary service, diagnostic category, and outcome were collected from the pediatric department database. Results: During the combined ICU period, there were 104 pediatric patients admitted with a median age of 18 months (IQR 6-48). Primary admitting service was surgical (56.7%). The most common non-surgical admission category was infectious (71%). The overall mortality rate was 49%. There were 142 admissions to the dedicated PICU during the study period with 62% being non-surgical. Among non-surgical admissions, infectious category was most common (43.2%). Median age of admissions was 36 months (IQR 6-120), and overall mortality rate was 34.5%. Conclusions: Since opening a standalone PICU, total admissions and non-surgical admissions have increased. Based on a previous study at KH, non-surgical admissions of infectious category have been shown to have a higher mortality rate in our PICU, yet overall mortality rate has declined. This suggests that a dedicated PICU with pediatric trained staff can improve care of critically ill children.