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.

Additional Metadata
Keywords Child, Critical care, Mortality, Outcome assessment (healthcare)
Persistent URL dx.doi.org/10.1186/s12887-019-1646-9, hdl.handle.net/1765/118744
Journal B M C Pediatrics
Citation
Verlaat, C.W.M, Wubben, N. (Nina), Visser, I.H.E, Hazelzet, J.A, van Waardenburg, D.A, van Dam, N.A.M, … van den Boogaard, M. (2019). Retrospective cohort study on factors associated with mortality in high-risk pediatric critical care patients in the Netherlands. B M C Pediatrics, 19(1). doi:10.1186/s12887-019-1646-9