Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands

Carin W. Verlaat, Nina Wubben, Idse H. Visser, Jan A. Hazelzet, Dick van Waardenburg, Nicolette A. van Dam, Nicolaas J. Jansen, Marc van Heerde, Matthijs de Hoog, Martin Kneyber, Maaike Riedijk, Johannes van der Hoeven, Joris Lemson, Mark van den Boogaard

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Abstract

Background: High-risk patients in the pediatric intensive care unit (PICU) contribute substantially to PICU-mortality. Complex chronic conditions (CCCs) are associated with death. However, it is unknown whether CCCs also increase mortality in the high-risk PICU-patient. The objective of this study is to determine if CCCs or other factors are associated with mortality in this group. Methods: Retrospective cohort study from a national PICU-database (2006-2012, n = 30,778). High-risk PICU-patients, defined as patients < 18 years with a predicted mortality risk > 30% according to either the recalibrated Pediatric Risk of Mortality-II (PRISM) or the Paediatric Index of Mortality 2 (PIM2), were included. Patients with a cardiac arrest before PICU-admission were excluded. Results: In total, 492 high-risk PICU patients with mean predicted risk of 24.8% (SD 22.8%) according to recalibrated PIM2 and 40.0% (SD 23.8%) according to recalibrated PRISM were included of which 39.6% died. No association was found between CCCs and non-survival (odds ratio 0.99; 95% CI 0.62-1.59). Higher Glasgow coma scale at PICU admission was associated with lower mortality (odds ratio 0.91; 95% CI 0.87-0.96). Conclusions: Complex chronic conditions are not associated with mortality in high-risk PICU patients.
Original languageEnglish
Article number274
JournalBMC Pediatrics
Volume19
Issue number1
DOIs
Publication statusPublished - 6 Aug 2019

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Verlaat, C. W., Wubben, N., Visser, I. H., Hazelzet, J. A., van Waardenburg, D., van Dam, N. A., ... van den Boogaard, M. (2019). Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands. BMC Pediatrics, 19(1), [274]. https://doi.org/10.1186/s12887-019-1646-9