Admission Patterns and Outcome in Pediatric Intensive Care Unit at Althawra Hospital: Al-Bayda, Libya

Abstract

A retrospective cross sectional descriptive study to all children from age groups (1month to 15 years) presenting with critical illnesses to the PICU at the pediatric department of Al –Thawra Hospital, from June 2015 to December 2015. A total of 1043 children  were admitted to PICU at Al Thawra Hospital, 54.1% were male and 45.9% were female with ratio male to female  1.1:1.  Age distribution showed that 51% were infants (1month to 1year). Respiratory system, central nervous system, and gastrointestinal diseases (32.3%, 28 %, 13 %) respectively were the most common diseases requiring PICU admission, followed by infectious diseases (7%) cardiovascular (6%), others which include poisoning and trauma (7%), and least common endocrine (2%), hematology (1.3%), nephrology (1%), metabolic ( 0.7%), and oncology (0.5%). The overall mortality rate was 30 (2.87%)  with  higher proportion of males (22\30) died following admission compared to admitted females (8\30) and these differences  were statistically significant. Infants had the highest proportion of the total death 22\30 which was statistically significant. Sepsis was the most common cause of total death 7\30 patients         ( 23.33%) followed by  6\30 patients ( 20%) for each of CHD and pneumonia followed by couple patients (6.6%) for each of cerebral palsy, convulsion and others. One patient (3.33%) each for encephalitis, acute gastroenteritis, anemia, chronic renal failure, and malignancy. Nine hundred and five patients (86.76%)  improved and discharged in satisfactory condition, 92 (8.82%) patients left against medical advice (LAMA), 61 (1,53%) patients were referred to more specified hospital and 30 patients died during the studied period. The estimated fatality rate was (2.87%). Infection remains a major problem for patients in intensive care units and associated with considerable morbidity and mortality. Pneumonia and congenital heart diseases were the most next common cause of death. Therefore, these patients require early referral and timely institution of therapy for better outcome, and intensive care facilities should be expanded to decrease child mortality.