Clinical-Epidemiological Profile of Hospitalised Patients in Paediatric Intensive Care Unit

Abstract

Introduction: Paediatric intensive care units have made important advances in technology and assistance since the 1980s, which have made more favourable the prognosis of critically ill children all over the world. Objective: Identify the epidemiological profile and clinical outcomes of hospitalised children and adolescents in the Paediatric Intensive Care Unit of Hospital Vitória, Espirito Santo, Brazil. Methods: A descriptive and retrospective study carried out in the Paediatric Intensive Care Unit of Hospital Infantil Nossa Senhora da Glória in the city of Vitória, Espirito Santo, Brazil. Age, sex, hospitalisation diagnosis, progression to discharge/death, and length of hospital admission were obtained from the Sector of Medical and Hospital Statistics Files between 2011 and 2012. For the descriptive analysis, categorical variables were expressed as absolute and percentage, and the continuous variables in average and standard deviation. For comparison, Pearson's chi-squared tests, Fisher's test, and Student's t test were used and p values <0.05 with confidence interval of 95% were considered statistically significant. Results: Of the 609 patients analysed, 342 (56.2%) were male (mean age: 72.7 ± 71.3 months). Respiratory disease, postoperative processes, and trauma were the main causes of hospitalisation. The average duration of hospitalization was 6.9 ± 5.5 days; 514 (84.4%) patients were discharged, 95 (15.6%) died, and of those, 53 (55.7%) died in less than 72 hours of hospitalisation. Conclusion: Most of the patients were less than 2 years of age. The leading causes of hospitalisation were respiratory disease (pneumonia, bronchiolitis, and asthma), sepsis, and head injury, which was the major cause of the trauma motivated by violence. The average hospital admission in the unit was one week and the mortality rate was 15.6%, with one third of the deaths recorded in the first 72 hours of hospitalisation.

Adesão ao bundle de inserção de cateter venoso central em unidades neonatais e pediátricas

“…The technical and scientific advances related to invasive procedures have led to reduced infant mortality and increased survival rate of preterm newborns, which has changed the profile of care, raising the demand for increasingly complex care required for the survival of this population (1)(2)(3) . The adoption of central venous catheters (CVC) in clinical practice was an important advance in the care to preterm newborns, ensuring safe venous access with less invasive, simple and low-cost techniques.…”

Revisão Sistemática Sobre a Epidemiologia Das Doenças Cardiovasculares E Respiratórias E Suas Associações Com a Poluição Do Ar Em Vitória/Es

“…Com relação à prevalência de hipertensão em adolescentes brasileiros, a estimativa calculada por Magliano et al 40 foi de 8,1% (IC95%: 6,2-10,5) para a população geral, com pequenas variações entre homens (8,7%; IC95%: 5,8-13,0) e mulheres (6,3%, IC95%: 4,4-9,0). Em comparação aos estudos conduzidos em Vitória, as estimativas apresentam amplitude maior do que a encontrado em âmbito nacional, variando de 3,4-14,8% nos quatro estudos abordando adolescentes 21,22,24,25 . Deve-se lembrar, contudo, que muitos desses estudos foram conduzidos em amostras mistas de crianças e adolescentes e que a definição da faixa etária específica à adolescência varia entre os artigos, sendo essas possíveis explicações para a variação entre os estudos.…”

“…Esses dados estão de acordo e são similares com os apresentados para a cidade de Vitória. No entanto, deve-se notar que os dois artigos incluídos nesta revisão com dados da cidade de Vitória são bastante diferentes entre si 23,25 , variando de 0,2-5,6%. A principal razão para essa disparidade está no modo de amostragem dos artigos, visto que aquele que apresentou maior prevalência teve como foco indivíduos internados em unidades de terapia intensiva pediátrica.…”

“…Considerando-se o estudo conduzido por Batista et al 25 , nota-se que a prevalência absoluta é significativamente menor do que qualquer dado obtido em amostras nacionais. Deve-se considerar que esse estudo incluiu apenas pacientes internados em unidades pediátricas de tratamento intensivo, uma condição completamente atípica e diferente dos processos de amostragem empregados nos estudos de âmbito nacional.…”

Factors Associated With the Clinical Deterioration Recognized by an Early Warning Pediatric Score

“…Studies show that conditions such as age under 1 or 2 years old, male gender and respiratory diseases were more prevalent in children admitted to the ICU. [7][8][9][10][11][12] Risk factors such as respiratory history and history of previous hospitalization were associated with the need for hospitalization in children under one year old. 13 In this context, pediatric patients undergoing clinical deterioration require the health teams to be prepared to early recognize the signs of severity and to provide prompt care in order to avoid serious adverse events resulting from their clinical worsening.…”