Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit

Abstract

To study the profile and outcomes of children admitted to a tertiary level pediatric intensive care unit (PICU) in India. Prospective observational study. PICU Subjects: Patients admitted to the PICU between January1998 to December 2000. Prospective study of patient demographics, PRISM III scores, diagnoses, treatment, morbidity and mortality of all PICU admissions. 948 children were admitted to the PICU. Mean age was 41.48 months. Male to female ratio was 2.95:1. Mean PRISM III score on admission was 18.50. Diagnoses included respiratory (19.7%), cardiac (9.7%), neurological (17.9%), infectious (12.5%), trauma (11.7%), other surgical (8.8%). One hundred ninety six children (20.68%) required mechanical ventilation. Average duration of ventilation was 6.39 days. Twenty seven children (30.7 children/1000 admissions) had acute respiratory distress syndrome. Gross mortality was 6.7% (59 patients). PRISM III adjusted mortality was directly proportional to PRISM III scores. 49.5% of non-survivors had multiorgan failure. Average length of PICU stay was 4.52 + 2.6 days. Complications commonly encountered were atelectasis (6.37%), accidental extubation (2%), and pneumothorax (0.9%). Incidence of nosocomial infections was 16.86%. Conclusions: Our data appears to be similar with regard to PRISM III scores and adjusted mortality, length of the PICU stay, and duration of ventilation, to previously published western data. Multiorgan failure remains a major cause of death. As expected, dengue and malaria were common. Incidence of nosocomial infections was somewhat high. Interestingly, more boys got admitted to the PICU as compared to girls. Clearly more studies are required to assess the overall outcome of critically ill children in India.