Pediatric hospitalizations at two different setting community hospitals in north India: Implications for regionalization of care

Garg, Pankaj

doi:10.1007/s12098-009-0119-9

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…The mortality percentage is similar to other PICUs [1, 9, 14, 16, 17, 24]. Infectious diseases were the most common cause of PICU admission and mortality which is also seen in some recent studies [13–15, 18], in contrast to very low contribution of the same in western countries [16, 17, 24]. …”

Section: Discussionsupporting

confidence: 80%

“…Most of the studies depicting profile of patients presenting in emergency departments and those treated in PICU are either from the developed countries [5–12] or from the metropolitan cities of India [13–15]. Even continent-wide directories of profiles and outcomes of patients attending emergency care and admitted to pediatric intensive care have been prepared [16, 17].…”

Section: Introductionmentioning

confidence: 99%

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Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India

Shukla

Nimbalkar

Phatak³

et al. 2014

International Journal of Pediatrics

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Objective. Children have limited physiological reserve that deteriorates rapidly. Present study profiled patients admitted to PICU and determined PIM2 score applicability in Indian setting. Patients and Methods. Prospective observational study. Results. In 742 consecutive admissions, male : female ratio was 1.5 : 1, 35.6% patients were ventilated, observed mortality was 7%, and 26.4% were <1 year. The profile included septicemia and septic shock (29.6%), anemia (27.1%), pneumonia (19.6%), and meningitis and encephalitis (17.2%). For the first year, sensitivity of PIM2 was 65.8% and specificity was 71% for cutoff value at 1.9 by ROC curve analysis. The area under the curve was 0.724 (95% CI: 0.69, 0.76). This cutoff was validated for second year data yielding similar sensitivity (70.6%) and specificity (65%). Logistic regression analysis (LRA) over entire data revealed various variables independently associated with mortality along with PIM2 score. Another logistic model with same input variables except PIM2 yielded the same significant variables with Nagelkerke R square of 0.388 and correct classification of 78.5 revealing contribution of PIM2 in predicting mortality is meager. Conclusion. Infectious diseases were the commonest cause of PICU admission and mortality. PIM2 scoring did not explain the outcome adequately, suggesting need for recalibration. Following PALS/GEM guidelines was associated with better outcome.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India

Shukla

Nimbalkar

Phatak³

et al. 2014

International Journal of Pediatrics

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“…Acute Gastroenteritis comprised of 278 (28.5%). Few other studies 5,6,7,9,10,11,12 showed similar fi ndings with respiratory and diarrheal diseases on top of the morbidity list.…”

Section: Paudel Km Et Almentioning

confidence: 62%

Review of Paediatrics Inpatient at a Zonal Hospital

Paudel

Sharma

2013

J. Nepal Paedtr. Soc.

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Introduction: Childhood illnesses cause significant number of admissions in different level hospitals. This retrospective study was undertaken to analyze the morbidity pattern in the Paediatric ward at a Zonal Hospital with aim that the results obtained will help in planning, prioritizing and implementing preventive, promotive and curative health care activities of the children in resource poor community. Materials and Methods: This study was carried out retrospectively for one year from July/Aug 2010 -June/July 2011. Age, sex, diagnosis, month of admission, duration of admission and the frequency of diseases were evaluated. Results: A total number of 977 patients were admitted during the study period. There were 579(59%) male and 398(41%) female children. Less than five years age group accounted for 569(58%) excluding the neonates. In the study period, respiratory tract infections were the commonest cause of admission 309(31.6%), gastrointestinal including diarrhoeal diseases were 278(28.5%), enteric fever comprised of 69(7%), and other diseases comprised of about 390(39.5%). Of the total admissions, CNS diseases comprised of 128(13%) of which 29(3%) were meningitis and meningoencephalitis. Sixty seven (52%) of the total CNS cases were due to febrile convulsion. Renal and cardiovascular diseases were 8.5% and 1.5% respectively. Conclusion: Children under five years of age being the most common age group amongst all, with respiratory and gastrointestinal diseases still being the most predominant cause of paediatric morbidity; community level interventions including IMCI should be strengthened for reducing hospital admissions, along with allocation of hospital beds and supplies as per morbidity pattern.

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“…Additionally, these estimates may not be accurate due to imputation methods ( 19 ). Many studies have reported the epidemiology of acute pediatric illness in a single hospital or country, but fail to provide regional or global estimates ( 20 – 22 ). To address these gaps, we conducted a systematic review and meta-analysis to determine common causes of pediatric hospital mortality and admission in LMICs.…”

Section: Introductionmentioning

confidence: 99%

Etiology of hospital mortality in children living in low- and middle-income countries: a systematic review and meta-analysis

Kortz,

Mediratta,

Smith

et al. 2024

Front. Pediatr.

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In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs. We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2,000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1,000 admissions with 95% confidence intervals (95% CI). Our search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95% CI 3.4%–4.7%]. The most common causes of mortality (deaths/1,000 admissions) were infectious [12 (95% CI 9–14)]; respiratory [9 (95% CI 5–13)]; and gastrointestinal [9 (95% CI 6–11)]. Common causes of admission (cases/1,000 admissions) were respiratory [255 (95% CI 231–280)]; infectious [214 (95% CI 193–234)]; and gastrointestinal [166 (95% CI 143–190)]. We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs. Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation.

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Pediatric hospitalizations at two different setting community hospitals in north India: Implications for regionalization of care

Cited by 4 publications

References 10 publications

Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India

Critical Analysis of PIM2 Score Applicability in a Tertiary Care PICU in Western India

Review of Paediatrics Inpatient at a Zonal Hospital

Etiology of hospital mortality in children living in low- and middle-income countries: a systematic review and meta-analysis

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