TY - JOUR
T1 - Pediatric intensive care outcomes
T2 - Development of new morbidities during pediatric critical care
AU - Pollack, Murray M.
AU - Holubkov, Richard
AU - Funai, Tomohiko
AU - Clark, Amy
AU - Berger, John T.
AU - Meert, Kathleen
AU - Newth, Christopher J.L.
AU - Shanley, Thomas
AU - Moler, Frank
AU - Carcillo, Joseph
AU - Berg, Robert A.
AU - Dalton, Heidi
AU - Wessel, David L.
AU - Harrison, Rick E.
AU - Doctor, Allan
AU - Dean, J. Michael
AU - Jenkins, Tammara L.
N1 - Publisher Copyright:
Copyright © 2014 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
PY - 2014/11/10
Y1 - 2014/11/10
N2 - Conclusions: The prevalence of new morbidity was 4.8%, twice the mortality rate, and occurred in essentially all types of patients, in relatively equal proportions, and involved all aspects of function. Compared with historical data, it is possible that pediatric critical care has exchanged improved mortality rates for increased morbidity rates.Measurements and Main Results: The main outcomes measures were hospital discharge functional status measured by Functional Status Scale scores and new morbidity defined as an increase in the Functional Status Scale of more than or equal to 3. Of the 5,017 patients, there were 242 new morbidities (4.8%), 99 PICU deaths (2.0%), and 120 hospital deaths (2.4%). Both morbidity and mortality rates differed (p < 0.001) among the sites. The worst functional status profile was on PICU discharge and improved on hospital discharge. On hospital discharge, the good category decreased from a baseline of 72% to 63%, mild abnormality increased from 10% to 15%, moderate abnormality status increased from 13% to 14%, severe status increased from 4% to 5%, and very severe was unchanged at 1%. The highest new morbidity rates were in the neurological diagnoses (7.3%), acquired cardiovascular disease (5.9%), cancer (5.3%), and congenital cardiovascular disease (4.9%). New morbidities occurred in all ages with more in those under 12 months. New morbidities involved all Functional Status Scale domains with the highest proportions involving respiratory, motor, and feeding dysfunction.Objective: To investigate significant new morbidities associated with pediatric critical care.Design: Randomly selected, prospective cohort.Setting: PICU patients from eight medical and cardiac PICUs.Patients: This was a randomly selected, prospective cohort of PICU patients from eight medical and cardiac PICUs.
AB - Conclusions: The prevalence of new morbidity was 4.8%, twice the mortality rate, and occurred in essentially all types of patients, in relatively equal proportions, and involved all aspects of function. Compared with historical data, it is possible that pediatric critical care has exchanged improved mortality rates for increased morbidity rates.Measurements and Main Results: The main outcomes measures were hospital discharge functional status measured by Functional Status Scale scores and new morbidity defined as an increase in the Functional Status Scale of more than or equal to 3. Of the 5,017 patients, there were 242 new morbidities (4.8%), 99 PICU deaths (2.0%), and 120 hospital deaths (2.4%). Both morbidity and mortality rates differed (p < 0.001) among the sites. The worst functional status profile was on PICU discharge and improved on hospital discharge. On hospital discharge, the good category decreased from a baseline of 72% to 63%, mild abnormality increased from 10% to 15%, moderate abnormality status increased from 13% to 14%, severe status increased from 4% to 5%, and very severe was unchanged at 1%. The highest new morbidity rates were in the neurological diagnoses (7.3%), acquired cardiovascular disease (5.9%), cancer (5.3%), and congenital cardiovascular disease (4.9%). New morbidities occurred in all ages with more in those under 12 months. New morbidities involved all Functional Status Scale domains with the highest proportions involving respiratory, motor, and feeding dysfunction.Objective: To investigate significant new morbidities associated with pediatric critical care.Design: Randomly selected, prospective cohort.Setting: PICU patients from eight medical and cardiac PICUs.Patients: This was a randomly selected, prospective cohort of PICU patients from eight medical and cardiac PICUs.
KW - Critical care
KW - Functional status
KW - Functional status score
KW - Intensive care
KW - Morbidity
KW - Outcome prediction
KW - Pediatric critical care
KW - Pediatric intensive care
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=84928297920&partnerID=8YFLogxK
U2 - 10.1097/PCC.0000000000000250
DO - 10.1097/PCC.0000000000000250
M3 - Article
C2 - 25226501
AN - SCOPUS:84928297920
SN - 1529-7535
VL - 15
SP - 821
EP - 827
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 9
ER -