Admission Pattern and Treatment Outcome in Pediatric Intensive Care Unit in Al Zahraa Teaching Hospital, Iraq, Najaf

Abstract

Background: The Pediatric Intensive Care Unit (PICU) represents a specialized healthcare setting dedicated to providing critical care for infants, children, and adolescents facing severe and life-threatening medical conditions. The rate of pediatric mortality in the Pediatric Intensive Care Unit (PICU) varies worldwide, reflecting the diverse healthcare landscapes and socioeconomic factors influencing pediatric critical care outcomes. The objective of this study was to describe the pattern of admission and outcome of patients who received intensive care. Patients and Methods: A retrospective study in which records of admissions (from 1^st of January 2019 to 31 December 2023) were obtained from the PICU patient's file in Al Zahraa Teaching, Najaf, Iraq. Data used from the records included age, sex, residency, address, source of admission, diagnosis, duration of stay in the unit, need for intubation and mechanical ventilation, and patient outcome.

Results: A total number of 1501 patients were admitted to the PICU during the study period. The patients were referred mainly from the Emergency Room 47% followed by the neonatal intensive care unit 21%. The case fatality rate was 54.1%. the main cause of death was RDS, sepsis, meningitis, and congenital heart diseases (29.2, 8.5, 6.6, and 6.6% respectively). 47.9% of PICU deaths occurred in patients admitted from the ER followed by NICU 24.2%. (P value 0.043, OR 1.082, 95% CI 1.002-1.168). The mean age of dead PICU patients was 15.697±32.79 months versus 23.301±39.91 months for discharged outcome (P value 0.000). Hospital stay length mean for PICU dead patients was 5.1±3.8 days versus 6.173±3.8 days for discharged patients (P value 0.000).  That means the smaller age patients carry a higher risk of death in PICU, also the situation with fewer hospital stays days.  Conclusion: In conclusion, this study showed the case fatality rate was high (54.7%.). The most common causes of admission and death were RDS (22.7% and 29.2% respectively). The highest percentage of death occurs in the infant age group (78.1%). Neither gender nor residency represents a risk factor for PICU patient's death but endotracheal intubation does. The fewer days of hospital stay carry a higher risk factor for death.