Factors Associated With Mortality in Low-Risk Pediatric Critical Care Patients in The Netherlands

Carin W. Verlaat*, Idse H. Visser, Nina Wubben, Jan A. Hazelzet, Joris Lemson, Dick Van Waardenburg, Douwe van der Heide, Nicolette A. van Dam, Nicolaas J. Jansen, Mark van Heerde, Cynthia van der Starre, Roelie van Asperen, Martin Kneyber, Job B. van Woensel, Mark van den Boogaard, Johannes van der Hoeven, SKIC Dutch Collaborative PICU Res

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

Objective: To determine differences between survivors and non-survivors and factors associated with mortality in pediatric intensive care patients with low risk of mortality.

Design: Retrospective cohort study.

Setting: Patients were selected from a national database including all admissions to the PICUs in The Netherlands between 2006 and 2012.

Patients: Patients less than 18 years old admitted to the PICU with a predicted mortality risk lower than 1% according to either the recalibrated Pediatric Risk of Mortality or the Pediatric Index of Mortality 2 were included.

Interventions: None.

Measurements and Main Results: In total, 16,874 low-risk admissions were included of which 86 patients (0.5%) died. Nonsurvivors had more unplanned admissions (74.4% vs 38.5%; p <0.001), had more complex chronic conditions (76.7% vs 58.8%; p = 0.001), were more often mechanically ventilated (88.1% vs 34.9%; p <0.001), and had a longer length of stay (median, 11 [interquartile range, 5-32] d vs median, 3 [interquartile range, 2-5] d; p <0.001) when compared with survivors. Factors significantly associated with mortality were complex chronic conditions (odds ratio, 3.29; 95% CI, 1.97-5.50), unplanned admissions (odds ratio, 5.78; 95% CI, 3.40-9.81), and admissions in spring/summer (odds ratio, 1.67; 95% CI, 1.08-2.58).

Conclusions: Nonsurvivors in the PICU with a low predicted mortality risk have recognizable risk factors including complex chronic condition and unplanned admissions.

Original languageEnglish
Pages (from-to)E155-E161
Number of pages7
JournalPediatric critical care medicine
Volume18
Issue number4
DOIs
Publication statusPublished - Apr 2017

Keywords

  • child
  • chronic complex condition(s)
  • mortality
  • outcome assessment (healthcare)
  • pediatric intensive care
  • COMPLEX CHRONIC CONDITIONS
  • LENGTH-OF-STAY
  • INTENSIVE-CARE
  • ADVERSE EVENTS
  • HOSPITAL MORTALITY
  • EXCESS MORTALITY
  • CHILDREN
  • UNIT
  • PREVALENCE
  • PREDICTION

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