Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands

Abstract Background High-risk patients in the pediatric intensive care unit (PICU) contribute substantially to PICU-mortality. Complex chronic conditions (CCCs) are associated with death. However, it is unknown whether CCCs also increase mortality in the high-risk PICU-patient. The objective of this study is to determine if CCCs or other factors are associated with mortality in this group. Methods Retrospective cohort study from a national PICU-database (2006–2012, n = 30,778). High-risk PICU-patients, defined as patients < 18 years with a predicted mortality risk > 30% according to eith... Mehr ...

Verfasser: Carin W. Verlaat
Nina Wubben
Idse H. Visser
Jan A. Hazelzet
SKIC (Dutch collaborative PICU research network)
Johannes van der Hoeven
Joris Lemson
Mark van den Boogaard
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: BMC Pediatrics, Vol 19, Iss 1, Pp 1-6 (2019)
Verlag/Hrsg.: BMC
Schlagwörter: Child / Critical care / Mortality / Outcome assessment (healthcare) / Pediatrics / RJ1-570
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29169415
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1186/s12887-019-1646-9

Abstract Background High-risk patients in the pediatric intensive care unit (PICU) contribute substantially to PICU-mortality. Complex chronic conditions (CCCs) are associated with death. However, it is unknown whether CCCs also increase mortality in the high-risk PICU-patient. The objective of this study is to determine if CCCs or other factors are associated with mortality in this group. Methods Retrospective cohort study from a national PICU-database (2006–2012, n = 30,778). High-risk PICU-patients, defined as patients < 18 years with a predicted mortality risk > 30% according to either the recalibrated Pediatric Risk of Mortality-II (PRISM) or the Paediatric Index of Mortality 2 (PIM2), were included. Patients with a cardiac arrest before PICU-admission were excluded. Results In total, 492 high-risk PICU patients with mean predicted risk of 24.8% (SD 22.8%) according to recalibrated PIM2 and 40.0% (SD 23.8%) according to recalibrated PRISM were included of which 39.6% died. No association was found between CCCs and non-survival (odds ratio 0.99; 95% CI 0.62–1.59). Higher Glasgow coma scale at PICU admission was associated with lower mortality (odds ratio 0.91; 95% CI 0.87–0.96). Conclusions Complex chronic conditions are not associated with mortality in high-risk PICU patients.