TY - JOUR
T1 - Factors Associated With Mortality in Low-Risk Pediatric Critical Care Patients in The Netherlands
AU - Verlaat, Carin W.
AU - Visser, Idse H.
AU - Wubben, Nina
AU - Hazelzet, Jan A.
AU - Lemson, Joris
AU - Van Waardenburg, Dick
AU - van der Heide, Douwe
AU - van Dam, Nicolette A.
AU - Jansen, Nicolaas J.
AU - van Heerde, Mark
AU - van der Starre, Cynthia
AU - van Asperen, Roelie
AU - Kneyber, Martin
AU - van Woensel, Job B.
AU - van den Boogaard, Mark
AU - van der Hoeven, Johannes
AU - SKIC Dutch Collaborative PICU Res
PY - 2017/4
Y1 - 2017/4
N2 - 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.
AB - 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.
KW - child
KW - chronic complex condition(s)
KW - mortality
KW - outcome assessment (healthcare)
KW - pediatric intensive care
KW - COMPLEX CHRONIC CONDITIONS
KW - LENGTH-OF-STAY
KW - INTENSIVE-CARE
KW - ADVERSE EVENTS
KW - HOSPITAL MORTALITY
KW - EXCESS MORTALITY
KW - CHILDREN
KW - UNIT
KW - PREVALENCE
KW - PREDICTION
U2 - 10.1097/PCC.0000000000001086
DO - 10.1097/PCC.0000000000001086
M3 - Article
SN - 1529-7535
VL - 18
SP - E155-E161
JO - Pediatric critical care medicine
JF - Pediatric critical care medicine
IS - 4
ER -