TY - JOUR
T1 - Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands
AU - Verlaat, Carin W.
AU - Wubben, Nina
AU - Visser, Idse H.
AU - Hazelzet, Jan A.
AU - van Waardenburg, Dick
AU - van Dam, Nicolette A.
AU - Jansen, Nicolaas J.
AU - van Heerde, Marc
AU - de Hoog, Matthijs
AU - Kneyber, Martin
AU - Riedijk, Maaike
AU - van der Hoeven, Johannes
AU - Lemson, Joris
AU - van den Boogaard, Mark
PY - 2019/8/6
Y1 - 2019/8/6
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85070446904&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31387556
U2 - https://doi.org/10.1186/s12887-019-1646-9
DO - https://doi.org/10.1186/s12887-019-1646-9
M3 - Article
C2 - 31387556
SN - 1471-2431
VL - 19
JO - BMC Pediatrics
JF - BMC Pediatrics
IS - 1
M1 - 274
ER -