Abstract
Objective/aim
The aim of the study was to quantify excess mortality in children after admission to a Pediatric Intensive Care Unit (PICU), compared to the age and sex matched general Swedish population.
Design
Single-center, retrospective cohort study.
Setting
Registry study of hospital registers, a national population register and Statistics Sweden.
Patients
Children admitted to a tertiary PICU in Sweden in 2008–2016.
Interventions
None.
Main results
In total, 6,487 admissions (4,682 patients) were included in the study. During the study period 444 patients died. Median follow-up time for the entire PICU cohort was 7.2 years (IQR 5.0–9.9 years). Patients were divided into four different age groups (0–28 d, > 28 d -1 yr, > 1–4 yr, and > 4 yr) and four different risk stratification groups [Predicted Death Rate (PDR) intervals: 0–10%, > 10–25%, > 25–50%, and > 50%] at admission. Readmission was seen in 929 (19.8%) patients. The Standardized Mortality Ratios (SMRs) were calculated using the matched Swedish population as a reference group. The SMR for the entire study group was 49.8 (95% CI: 44.8–55.4). For patients with repeated PICU admissions SMR was 108.0 (95% CI: 91.9–126.9), and after four years 33.9 (95% CI: 23.9–48.0). Patients with a single admission had a SMR of 35.2 (95% CI: 30.5–40.6), and after four years 11.0 (95% CI: 7.0–17.6). The highest SMRs were seen in readmitted children with oncology/hematology (SMR = 358) and neurologic (SMR = 192) diagnosis. Children aged >1–4 years showed the highest SMR (325). In PDR group 0–10% children with repeated PICU admissions (n = 798), had a SMR of 100.
Conclusion
Compared to the matched Swedish population, SMRs were greatly elevated up to four years after PICU admission, declining from over 100 to 33 for patients with repeated PICU admissions, and from 35 to 11 for patients with a single PICU admission.
Funder
Her Royal Highness Crown Princess Lovisa Foundation
Publisher
Public Library of Science (PLoS)
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献