Outcomes Following Intensive Care Unit Admission in a Pediatric Cohort in Malawi
| Autor: | Meghan Prin, John Sincavage, Anthony G. Charles, Clement Kadyaudzu, Michael R. Phillips, Laura N. Purcell |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Malawi medicine.medical_specialty Critical Care Anemia Population 030204 cardiovascular system & hematology law.invention 03 medical and health sciences symbols.namesake 0302 clinical medicine Risk Factors law Sepsis Intensive care Brain Injuries Traumatic Humans Medicine Hospital Mortality Prospective Studies 030212 general & internal medicine Poisson regression Child education Pediatric intensive care unit Respiratory Distress Syndrome education.field_of_study business.industry Infant Length of Stay medicine.disease Intensive care unit Intensive Care Units Infectious Diseases Child Preschool Relative risk Pediatrics Perinatology and Child Health Emergency medicine Cohort symbols Female business |
| Zdroj: | Journal of Tropical Pediatrics. 66:621-629 |
| ISSN: | 1465-3664 |
| Popis: | Introduction The burden of critical illness in low- and middle-income countries (LMICs) is high; however, there is a paucity of data describing pediatric critical care outcomes in this setting. Methods We performed a prospective observational study of the pediatric (≤18 years) intensive care population in Malawi, from August 2016 to May 2018. Data collected include patient demographics and clinical data, admission criteria and outcome. A multivariate Poisson regression was performed to determine risk factors for mortality. Results Over the study period, 499 patients were admitted to the intensive care unit (ICU) and 105 (21.0%) were children. The average age was 10.6 ± 5.4 years. Primary indications for ICU admission were sepsis (n = 30, 30.3%) and traumatic brain injury (TBI, n = 23, 23.2%). Of those who died, sepsis (n = 18, 32.7%), acute respiratory failure (n = 11, 20.0%) and TBI (n = 11, 20.0%) were the primary admission diagnoses. Overall, ICU mortality was 54.3% (n = 57). Multivariate regression for increased ICU mortality revealed: age ≤5 years [risk ratio (RR) 1.96, 95% CI 1.10–2.26, p Conclusions Pediatric ICU mortality is high. Predictors of mortality were age ≤5 years, anemia at ICU admission and the need for epinephrine support. Training of pediatric intensive care specialists and increased blood product availability may attenuate the high mortality for critically ill children in Malawi. |
| Databáze: | OpenAIRE |
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