All‐cause mortality in a pediatric intensive care unit at a teaching hospital in Amman, Jordan

Abstract

Background The aim of this study was to describe the main causes of admission to a general pediatric intensive care unit (PICU), and examine the main causes of mortality in this patient population. In addition, we describe the percentage of patients who died following a failed cardiopulmonary resuscitation (CPR) versus do not resuscitate (DNR) orders. Methods This was a retrospective, cohort study with a chart review of admissions and mortality cases that occurred in the PICU. Mortality rates in pediatric admissions are reported with a description of demographics, diagnosis, length of stay, use of mechanical ventilation, use of vasoactive agents, preexisting comorbidities, the presence of a DNR order, and final cause of mortality. Modes of mortality were described as failed CPR or a DNR order. Results During the study period there were 1,523 admissions to the PICU. Of those, 102 patients died with an overall mortality rate of 6.7%. Patients who died tended to be younger, and the majority (85%) had a preexisting comorbidity, with neuromuscular disease being the most common. The majority of the patients who died (69%) required invasive ventilation. The most common immediate cause of mortality was respiratory disease and the highest case fatality was among those with cardiac disease. Of those patients who died, 90% had failed CPR and 10% had a DNR order. Care was not withdrawn from any patient. Conclusion This study describes the diagnostic categories of children admitted to the PICU, with respiratory disease being the most common cause of admission and mortality. The majority of children who died had an existing comorbidity and did not have a DNR order at the time of their death.

Retracted Article: The Spiritual Dimension of Death: A Mini Review

“…In countries with available resources, overall mortality in a general PICU can be as low as 2.39%, while in developing countries the reported rates are much higher (16.5–45.5%). 1 Gilleland and Parshuram 2 reported that timely conversations about death as a possible outcome of PICU are an important part of high-quality intensive care. Informed conversations require preparation to provide families with the best available objective information.…”

The magnitude of pediatric mortality and determinant factors in intensive care units in a low-resource country, Ethiopia: a systematic review and meta-analysis

“…In our study, comorbidity was one of the determinant factors contributing to pediatric patients' mortality in PICU. This finding is supported by studies conducted in Jordan ( 23 ) and India ( 34 ). Comorbidities have been shown to have a significant impact on the clinical course, complications rate, and outcomes in the ICU.…”

“…In our review, two articles stated that the use of mechanical ventilators was the factor for pooled mortality of pediatric patients at PICU. This review is supported by studies conducted in Jordan ( 23 ) and the Netherlands ( 28 ). The possible explanation is that most patients who require mechanical ventilators are more critical than those who do not, and it stays in for a couple of days, thereby increasing mortality.…”

Incidence and types of congenital heart disease at a referral hospital in Jordan: retrospective study from a tertiary center

“…Most children ultimately diagnosed with CHD were referred for evaluation based on murmur or cyanosis ( 13 ). CHD is an important factor in both neonatal and childhood mortality in Jordan ( 17 , 18 ). Fetal echocardiography is available at some referral centers ( 19 ).…”