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 A
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 M
AU - Van Den Boogaard, Mark
AU - van der Hoeven, Johannes G.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: To determine differences between survivors and nonsurvivors 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 nonsurvivors 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
UR - http://www.scopus.com/inward/record.url?scp=85011798922&partnerID=8YFLogxK
U2 - 10.1097/PCC.0000000000001086
DO - 10.1097/PCC.0000000000001086
M3 - Article
C2 - 28178075
AN - SCOPUS:85011798922
SN - 1529-7535
VL - 18
SP - e155-e161
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 4
ER -