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Category: Volume 05 Issue 11 November 2017
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Title: A Retrospective Evaluation of Morbidity Pattern and Outcome of Patients Admitted into a Pediatric Intensive Care Unit in India

Authors: Dr Dhrubajyoti Mridha MD, Dr Sudip Saha MD, Prof. Dr Sutapa Ganguly MD, Dr Kallol Bose M.D

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.132

Abstract

Background: Intensive care has become very important in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports and are usually admitted into the pediatric intensive care unit (PICU) with the aim of achieving an outcome better than if the patients were admitted into other parts of the hospital. It becomes important to audit admissions and their outcome, which may help to modify practices if necessary following thorough introspection, leading to better patient outcomes.

Objective: To evaluate the morbidity pattern and outcome of admissions into the PICU of a tertiary care center in India.

Methods: A retrospective study in which records of admissions (January 2015 to August 2017) were obtained from the PICU records. Information retrieved included age, sex, weight, diagnosis, duration of stay in the unit, and outcome.

Results: Mean age of the studied 1231 patients was 28.5419 ± 36.8344 months; 55.2% were infants and 61.2%were males. The three most common disease categories admitted were Respiratory disease (32.3%), neurological disorders (17.0%), and Infection other than sepsis- (11.7%). The mean duration of stay in PICU was 7.42 ± 7.72 days. The overall mortality rate was 20.9%.

Conclusion: Mortality is moderate in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care greatly facilitates the care of critically ill patients giving desirable outcome if there is early referral.

Keywords: PICU admission, morbidity pattern, outcome of patients, India.

References

  1. Young MP, Birkmeyer JD. Potential reduction in mortality rates using an intensivist model to manage intensive care units. Eff Clin Pract. 2000;3:284-9.
  2. Earle M, Natera OM, Zaslavsky A. Outcome of pediatric intensive care at six centers in Mexico and Ecuador. Crit Care Med. 1997;25:1462-7.
  3. Cullen DJ, Sweitzer BJ, Bates DW, Burdick E, Edmondson A, Leape LL. Preventable adverse drug events in hospitalized patients: A comparative study of intensive care and general care units. Crit Care Med. 1997;25:1289-97.
  4. Pronovost P, Wu AW, Dorman T, Morlock L. Building safety into ICU care. J Crit Care. 2002;17:78-85.
  5. Fiser DH, Tilford JM, Roberson PK. Difference in pediatric ICU mortality risk over time. Crit Care Med. 1998;26:1737-43.
  6. Downes JJ. Development of paediatric critical care medicine how did we get here and why? In: Wheeler D, Wong H, Shanely T, eds. Paediatric Critical Care Medicine: Basic Science and Clinical Evidence. London: Springer; 2007:3-32.
  7. Khilnani P, Sarma D, Singh. Demographic profile and outcome analysis of tertiary level pediatric intensive care unit. Indian J Paediatr. 2004;71:587-91.
  8. Shah GS, Shah BK, Thapa A, Shah L, Mishra OP. Admission patterns and outcome in a pediatric intensive care unit in Nepal. Br J Med Med Res. 2014;4(30):4939-45.
  9. Haque A, Bano S. Clinical profile and outcome in a pediatric intensive care unit in Pakistan. J Coll Phys Surg Pakistan. 2009;19:534-5.
  10. Blessing I, Iyoha A, Pooboni SK ,Vuppali NK. Morbidity pattern and outcome of patients admitted into a pediatric intensive care unit in India. Ind J Clin Med. 2014;51-5.
  11. Choi KMS, Ng DKK, Wong SF. Assessment of the pediatric index of mortality (PIM) and the pediatric risk of mortality (PRISM) III score for prediction of mortality in a paediatric intensive care unit in Hong Kong. Hong Kong Med J. 2005;11:97-103.
  12. Bellad R, Rao S, Patil VD, Mahantshetti NS. Outcome of intensive care unit patients using pediatric risk of mortality (PRISM) score. Indian Pediatr. 2009;46:1091-2.
  13. Costa GA, Delgado AF, Ferraro A, Okay TS. Application of the pediatric risk of mortality score (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit. Clinics. 2010;65:1087-92.
  14. Haque A, Bano S. Improving outcome in pediatric intensive care unit in academic hospital in Pakistan. Pakistan J Med Sci. 2009;25:605-8.
  15. Singhal D, Kumar N, Puliyl JM, Singh SK, Srinivas V. Prediction of mortality by application of PRISM score in intensive care unit. Indian Pediatr. 2001;38:714-9.
  16. Pearson G, Shann F, Field D. Should pediatric intensive care be centralized? trent versus victoria. Lancet. 1997;349:1213-7.

Corresponding Author

Dr Dhrubajyoti Mridha

94 Vivekananda Park Kolkata India Pin 700063

Contact No 9883278392, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.