Mortality Rate and Risk Factors in Pediatric Intensive Care Unit of Imam Hossein Children's Hospital in Isfahan: A Prospective Cross-Sectional Study.

Abstract

Background: Various studies have conducted to report the mortality rates and its risk factors in pediatric intensive care unit. This study aimed to determine the mortality prevalence and risk factors in PICU of Imam Hossein Children's Hospital in Isfahan, which is the main referral pediatric hospital in the center of Iran.

Materials and methods: This study was performed on 311 patients during a period of 9 months. The questionnaire which included age, gender, length of stay in the PICU and hospital, mortality, history of resuscitation in other wards and readmission, the causes and sources of hospitalization, pediatric risk of mortality (PRISM)-III score, respiratory supports, morbidities like nosocomial infections, acute kidney injury (AKI), multiple organ dysfunction syndrome (MODS) confirmed by pediatric sequential organ failure assessment score (P-SOFA) and glycemic disorders was filled out.

Results: One hundred and seventy-seven (56.9%) were males and 103 (33%) were belonged to the age group of 12-59 months. The most prevalent causes of hospitalization were status epilepticus (12.9%) and pneumonia (11.2%). Mortality rate was 12.2%. The significant factors associated with mortality were readmission and history of resuscitation. PRISM-III index showed a significant difference between nonsurvivors and survivors (7.05 ± 6.36 vs. 3.36 ± 4.34, P = 0.001). Complications like AKI, hypoglycemia, MODS and disseminated intravascular coagulation (DIC), length of mechanical ventilation significantly correlated with mortality.

Conclusions: Mortality rate was less than that of other developing countries (12.2%) and this was associated with some risk factors included readmission, history of resuscitation, PRISM-III Index; complications like AKI, acute respiratory distress syndrome (ARDS), DIC, mechanical ventilation duration, MODS, hypoglycemia, and P-SOFA index.