The Main Causes of Mortality in Pediatric Intensive Care Unit in South West of Iran

Valavi, Ehsan; Aminzadeh, Majid; Shirvani, Elham; Jaafari, Leila; Simin, Madhooshi

doi:10.5812/zjrms.63006

Cited by 15 publications

(28 citation statements)

References 13 publications

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“…e majority of patients at the SUH PICU were infants who also constituted the highest age-related mortality. is was also reported in different studies performed in many developing countries with higher population of children [17,18]. is confirms the need to direct more resources to reduce the in-hospital mortality of this vulnerable age group.…”

Section: Discussionsupporting

confidence: 69%

Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources

Abdelatif

Mohammed

Mahmoud

et al. 2020

Critical Care Research and Practice

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Background. The pediatric intensive care units (PICUs) in developing countries have a higher mortality outcome due to a wide variety of causes. Identifying differences in the structure, patient characteristics, and outcome between PICUs with different resources may add evidence to the need for incorporating more PICUs with limited resources in the contemporary critical care research to improve the care provided for severely ill children. Methods. A retrospective study was conducted at Egyptian and Japanese PICUs as examples of resource-limited and resource-rich units, respectively. We collected and compared data of nonsurgical patients admitted between March 2018 and February 2019, including the patients’ demographics, diagnosis, PICU length of stay, outcome, predicted risk of mortality using pediatric index of mortality-2 (PIM-2), and functional neurological status using the Pediatric Cerebral Performance Category (PCPC) scale. Results. The Egyptian unit had a lower number of beds with a higher number of annual admission/bed than the Japanese unit. There was a shortage in the number of the skilled staff at the Egyptian unit. Nurse : patient ratios in both units were only similar at the nighttime (1 : 2). Most of the basic equipment and supplies were available at the Egyptian unit. Both actual and PIM-2 predicted mortalities were markedly higher for patients admitted to the Egyptian unit, and the mortality was significantly associated with age, severe sepsis, and PIM-2. The length of stay was shorter at the Egyptian unit. Conclusion. The inadequate structure and the burden of more severely ill children at the Egyptian unit appear to be the most important causes behind the higher mortality at this unit. Increasing the number of qualified staff and providing cost-effective equipment may help in improving the mortality outcome and the quality of care.

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Section: Discussionsupporting

confidence: 69%

Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources

Abdelatif

Mohammed

Mahmoud

et al. 2020

Critical Care Research and Practice

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“…The level of GCS of <8 has a factor in the mortality of PICU in our review. This finding is supported by studies conducted in Iran (30) and the Netherlands (31). The possible explanation for this factor was that decreased GCS level results in more critical patients and increased mortality.…”

Section: Discussionsupporting

confidence: 79%

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

et al. 2023

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BackgroundPediatric mortality after being admitted to a pediatric intensive care unit in Ethiopia is high when compared to high-income countries. There are limited studies regarding pediatric mortality in Ethiopia. This systematic review and meta-analysis aimed to assess the magnitude and predictors of pediatric mortality after being admitted to an intensive care unit in Ethiopia.MethodsThis review was conducted in Ethiopia after retrieving peer-reviewed articles and evaluating their quality using AMSTAR 2 criteria. An electronic database was used as a source of information, including PubMed, Google Scholar, and Africa Journal of Online Databases, using AND/OR Boolean operators. Random effects of the meta-analysis were used to show the pooled mortality of pediatric patients and its predictors. A funnel plot was used to assess the publication bias, and heterogeneity was also checked. The final result were expressed as an overall pooled percentage and odds ratio with a 95% confidence interval (CI) of < 0.05%.ResultsIn our review, eight studies were used for the final analysis with a total population of 2,345. The overall pooled mortality of pediatric patients after being admitted to the pediatric intensive care unit was 28.5% (95% CI: 19.06, 37.98). The pooled mortality determinant factors were included the use of a mechanical ventilator with an odds ratio (OR) of 2.64 (95% CI: 1.99, 3.30); the level of Glasgow Coma Scale <8 with an OR of 2.29 (95% CI: 1.38, 3.19); the presence of comorbidity with an OR of 2.18 (95% CI: 1.41, 2.95); and the use of inotropes with an OR of 2.36 (95% CI: 1.65, 3.06).ConclusionIn our review, the overall pooled mortality of pediatric patients after being admitted to the intensive care unit was high. Particular caution should be taken in patients on the use of mechanical ventilators, the level of Glasgow Coma Scale of <8, the presence of comorbidity, and the use of inotropes.Systematic review registrationhttps://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/, identifier: 1460.

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“…This result is analogous to research from Jimma, Ethiopia, which reported a high mortality rate in patients who stayed for more than 28 days 13 and Iran, which discovered a 2.49 times higher mortality rate in patients who stayed for longer than a week. 34 Our findings may be explained by the fact that patients who stay in the hospital for a long time are more likely to develop hospital-acquired infections.…”

Section: Discussionmentioning

confidence: 74%

Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study

Dendir¹,

Awoke²,

Alemu³

et al. 2023

PHMT

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Background Critical care is a multidisciplinary and interprofessional specialty devoted to treating patients who already have or are at danger of developing acute, life-threatening organ dysfunction. Due to the higher disease load and mortality from preventable illness, patient outcomes in intensive care units are challenging in settings with inadequate resources. This study aimed to determine factors associated with outcomes of pediatric patients admitted to intensive care units. Methods A cross-sectional study was conducted at Wolaita Sodo and Hawassa University teaching hospitals in southern Ethiopia. Data were entered and analyzed using SPSS version 25. Normality tests using the Shapiro–Wilk and Kolmogorov–Smirnov data were normally distributed. The frequency, percentage, and cross-tabulation of the different variables were then determined. Finally, the magnitude and associated factors were first analyzed using binary logistic regression and then multivariate logistic regression. Statistical significance was set at P < 0.05. Results A total of 396 Pediatric ICU patients were included in this study, and 165 (41.7%) deaths were recorded. The odds of patients from urban areas (AOR = 45%, CI 95%: 8%, 67% p-value = 0.025) were less likely to die than those in rural areas. Patients with co morbidities (AOR = 9.4, CI 95%: 4.5, 19.7, p = 0.000) were more likely to die than pediatric patients with no co-morbidities. Patients admitted with Acute respiratory distress syndrome (AOR = 12.86, CI 95%: 4.3, 39.2, p = 0.000) were more likely to die than those with not. Pediatric patients on mechanical ventilation (AOR = 3, CI 95%: 1.7, 5.9, p = 0.000) more likely to die than not mechanically ventilated. Conclusion Mortality of paediatric ICU patients was high (40.7%) in this study. Co-morbid disease, residency, the use of inotropes, and the length of ICU stay were all statistically significant predictors of death.

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The Main Causes of Mortality in Pediatric Intensive Care Unit in South West of Iran

Cited by 15 publications

References 13 publications

Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources

Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources

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

Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study

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