DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20211675

Pattern of admission and clinical outcome of patients admitted in pediatric intensive care unit of a rural tertiary health care centre

Vivek Parasher, Sachin Shaha, Rahul Khatri, Samarth Yadav, Sayan Das, Ujjwal Mittal

Abstract


Background: In the treatment of critically ill children needing specialized airway, respiratory, and hemodynamic assistance, intensive care has become very necessary and is typically admitted into the pediatric intensive care unit (PICU) in order to ensure a better result than if the patients were admitted to other sections of the hospital. To audit admissions and their findings are significant, which may help to change procedures after extensive introspection if appropriate, leading to improved patient outcomes. Objective were to examine pattern of admission and clinical outcome of patients admitted in the pediatric intensive care unit of a rural tertiary health care centre.

Methods: Information retrieved included age, sex, diagnosis, outcome, morbidity and mortality profile of patients admitted in PICU in the last five years.

Results: A total of 2810 patients were admitted into PICU. (1444) 51.3% were infants, and (1366) 48.6% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 1948 (69.3%) male and 862 (30.3%) female patients giving an M: F ratio of 2.27:1. The overall mortality rate was 2.4%.

Conclusions: In our PICU, mortality is low. We believe that the treatment of critically ill patients with desirable results is significantly facilitated by a well-equipped intensive care unit with advanced and creative intensive care in order to improve cost-effective patient care and prevent needless stretching of the PICU services, an extension of the pediatric wards is advocated.


Keywords


Mortality, Morbidity pattern, Intensive care unit, Children

Full Text:

PDF

References


Fiser DH. Outcome evaluations as measures of quality in pediatric intensive care. Pediatr Clin North Am. 1994;41(6):1423-38.

Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score. Crit Care Med. 1988;16(11):1110-6.

Wells M, Riera-Fanego JF, Luyt DK, Dance M, Lipman J. Poor discriminatory performance of the Pediatric Risk of Mortality (PRISM) score in a South African intensive care unit. Crit Care Med. 1996;24(9):1507-13.

Caldwell JC, Caldwell P. Changing health conditions. In: Reich MR, Marui E, eds. International Cooperation for health:problems, prospects and priorities. 2nd ed. MA;Auburn House;1998.

Frenk U, Bobadilla JL, Sepuúlveda J, Cervantes ML, Health transition in middle-income countries: new challenges for health care, Health Policy and Planning. 1989;4(1):29-39.

Department of National Health and Population Development Poliomyelitis eradication. Epidemiol Comments 25, 1996. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/00041414.htm. Accessed on 23 February 2021.

Jeena PM, Coovadia HM, Gouws E. Risk factors for neonatal tetanus in KwaZulu-Natal. S Afr Med J. 1997;87(1):46-8.

Bradshaw D, Schneider M, Dorrington R, Bourne DE, Laubscher R. South African cause-of-death profile in transition-1996 and future trends. S Afr Med J. 2002;92(8):618-23.

Pollack MM, Katz RW, Ruttimann UE, Getson PR. Improving the outcome and efficiency of intensive care: the impact of an intensivist. Crit Care Med. 1988;16(1):11-7.

Davis AL, Pollack MM, Cloup M, Cloup I, Wilkinson JD. Comparisons of French and U.S.A. pediatric intensive care units. Resuscitation. 1989;17(2):143-52.

Shann F. Australian view of paediatric intensive care in Britain. Lancet. 1993;342(8863):68.

Curtis JR, Cook DJ, Wall RJ, Angus DC, Bion J, Kacmarek R, et al. Intensive care unit quality improvement: a "how-to" guide for the interdisciplinary team. Crit Care Med. 2006;34(1):211-8.

Garland A. Improving the ICU: part 2. Chest. 2005;127(6):2165-79.

Luce JM, Rubenfeld GD. Can health care costs be reduced by limiting intensive care at the end of life? Am J Respir Crit Care Med. 2002;165(6):750-4.

Mehta A, Rosenthal VD, Mehta Y, Chakravarthy M, Todi SK, Sen N, et al. Device-associated nosocomial infection rates in intensive care units of seven Indian cities. Findings of the International Nosocomial Infection Control Consortium (INICC). J Hosp Infect. 2007;67(2):168-74.

Chelluri LP. Quality and performance improvement in critical care. Indian J Crit Care Med. 2008;12(2):67-76.

Brilli RJ, Spevetz A, Branson RD, Campbell GM, Cohen H, Dasta JF, et al; American College of Critical Care Medicine Task Force on Models of Critical Care Delivery. The American College of Critical Care Medicine Guidelines for the Defintion of an Intensivist and the Practice of Critical Care Medicine. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med. 2001;29(10):2007-19.

Kapil D, Bagga A. The profile and outcome of patients admitted to a pediatric intensive care unit. Indan J Paediatr. 1993;60(1):5–10.

Patil R. Profile of Patients Admitted in Paediatric ICU of A Tertiary Care Hospital: A Cross Sectional Study. Sage J. 2014.

Bhavari VL, Ambike DA, Pawar ND. Study of morbidity pattern and outcome of patients admitted in paediatric intensive care unit in tertiary care rural teaching hospital. Int J Contemp Pediatr 2019;6:2064-7.