Burden of respiratory illnesses in pediatric intensive care unit and predictors of mortality: Experience from a low resource country. Issue 8 (14th May 2019)

• Record Type: Journal Article
• Authors: Divecha, Chhaya; Tullu, Milind S.; Chaudhary, Satish
• Is Part Of: Pediatric pulmonology. Volume 54:Issue 8(2019)
• Page Start: 1234
• Page End: 1241
• Publication Date: 2019-05-14
• Subjects: bronchiolitis -- cardiorespiratory -- mortality -- PICU -- pneumonia -- PRISM III -- respiratory illness -- respiratory infections -- risk factors -- ventilation; Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.24351
• Languages: English
• ISSNs: 8755-6863

Abstract

Abstract: Introduction and Objectives: Acute respiratory infections (ARI), a major cause of childhood mortality and morbidity, place substantial burden on health services worldwide. Due to scarce data regarding respiratory illnesses requiring Pediatric intensive care unit (PICU) admissions (especially in low income/developing countries), we studied the burden of respiratory illnesses in the PICU and the risk factors contributing to mortality. Methods: This prospective observational study was conducted over 18 months. Children (aged 1 month to 12 years) admitted to the PICU for acute respiratory/cardiorespiratory illnesses were enrolled. Demographic and clinical details of the study population were recorded and tabulated. Risk factors contributing to mortality (severity of illness [PRISM III score], diagnosis/etiology, need for mechanical ventilation, immunocompromised status, malnutrition, and length of stay [LOS]) were analyzed (using the χ 2 test or Fischer Exact test). Results: Two hundred and ninety‐three children were enrolled (median age: 5 months; range, 1‐132 months; male/female: 181/112). Mean LOS in PICU was 5.25 ± 5.48 days and mean length of hospital stay of 14.82 ± 13.35 days. Mechanical ventilation was required in 62.8% cases. Pneumonia contributed to 66.89% of respiratory admissions and 91% of mortality. Ninety patients (30.7%) died; mortality being higher in cardiorespiratory cases (52.7%). PRISM III score and shock (respiratory cases) and age below 1 year (cardiorespiratory group) were significantly associated with higher mortality ( P < 0.05). Conclusions: Respiratory illnesses are a significant contributor to PICU admissions and are associated with significant mortality risk in presence of high PRISM III score and shock (respiratory group); and age below 1 year (cardiorespiratory group).