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

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 rec... Mehr ...

Verfasser: Verlaat, Carin W.
Wubben, Nina
Visser, Idse H.
Hazelzet, Jan A.
Van der Hoeven, Johannes
Lemson, Joris
van den Boogaard, Mark
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: SKIC Dutch Collaborative PICU Res , Verlaat , C W , Wubben , N , Visser , I H , Hazelzet , J A , Van der Hoeven , J , Lemson , J & van den Boogaard , M 2019 , ' Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands ' , BMC Pediatrics , vol. 19 , no. 1 , 274 . https://doi.org/10.1186/s12887-019-1646-9
Schlagwörter: Child / Critical care / Mortality / Outcome assessment (healthcare) / HOSPITAL CARDIAC-ARREST / INTENSIVE-CARE / CHILDREN / IMPACT / INDEX
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29192767
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/ec470bf5-7694-4328-bcf6-3a2cc3a71968

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.