Mortality of children treated in a pediatric intensive care unit versus other intensive care units

Abstract

Background: Korean children are often treated in Intensive Care Units (ICUs) rather than in Pediatric Intensive Care Units (PICUs). However, pediatric critical care (PCC) in ICUs, other than in PICUs, may have effects on patient's outcome. Objectives: To compare the PCC outcomes of pediatric patients in the PICU with the outcomes of pediatric patients in other ICUs. Methods: This is a retrospective study of pediatric patients treated in ICUs. The participants of this study were children aged < 18 years who were admitted to the ICUs from the Pediatric Department of Seoul St. Mary's Hospital from April 2009 to June 2017. Patients with hemato-oncologic diseases or those needing postoperative care were excluded. Results: Among the 429 ICU cases, 306 were PICU and 123 were ICU patients. The age (18 months vs. 26 months; P = 0.104) and male sex ratio (57% vs. 54%; P = 0.587) were not significantly different between PICU and other ICU patients. PICU patients (73%) were commonly admitted from another hospital compared with ICU patients (63%, P = 0.043). The pediatric index of mortality -3 score was not significantly different between the PICU and ICU patients (-4.3 vs -4.1; P = 0.128); the ICU and hospital length of stay were 5 days vs 5 days (P = 0.357) and 11 days vs 11 days (P = 0.317); and the mortality rate was 4% vs 11% (P = 0.008), respectively. Respiratory and neurologic complications were 5% vs 11% (P = 0.021) and 4% vs 2% (P = 0.282), respectively. The risk of mortality was higher for ICUs patients (odds ratio = 2.56; 95% CI = 1.11 - 5.87), adjusted for source of ICU admission, and type of ICU. Conclusions: Pediatric patients treated in a PICU had a lower mortality compared to those treated in other ICUs.