Admission Patterns and Outcome in a Pediatric Intensive Care Unit at Tobruk Hospital

Authors

  • Hawa Gresh Pediatric Department, Faculty of Medicine, Tobruk University –Libya
  • Rehab Othman Pediatric Department, Faculty of Medicine, Tobruk University –Libya

DOI:

https://doi.org/10.54172/mjsc.v33i4.293

Keywords:

Pediatric intensive care unit (PICU), children and mortality, Tobruk- Libya

Abstract

This study aims to describe the admission pattern and outcome of patients in the pediatric intensive care unit (PICU) at Tobruk medical center.  We have retrospectively reviewed medical files of PICU over the period from January to December of 2016 for children aged from 1month-15 years. A total of 1026 children were admitted to PICU at Tobruk medical center. Of the total, 55% were males and 44.9% were females with male to female ratio of 1.2: 1. Age distribution showed that 64% were infants (1month -1 year). Majority of admission during cold months (December, January, and February) had the highest admission rate. Central nervous system and respiratory system diseases (23%, 12%) respectively were the most diseases requiring PICU admission. Congenital heart diseases 10/26 (38.4%) was the most common cause of total death. 668(65%) patients improved and were discharged from ICU, and 201 (19.5%) were transferred to pediatric ward for further management and discharged in satisfactory condition. 99 (9.6%) patients left against medical advice, and 32 (3%) patients transferred to more specified hospital and 26 patient died (2.5%). The observed difference in the mortality was with the respect to age, length of stay, and the involved systems. Neurological system remains a major cause for admission in ICU mainly for febrile convulsion and was associated with considerable morbidity and mortality. Respiratory system was the second cause mainly for pneumonia, and CHD was the major cause of death. The results concluded that epidemiologic analysis of the pattern of patients admitted to our PICU showed different etiologies for admission

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References

Abebe, T., & Girmay, M. (2015). The epidemiological profile of pediatric patients admitted to the general intensive care unit in an ethiopian university hospital. International journal of general medicine, 8, 63. DOI: https://doi.org/10.2147/IJGM.S76378

Abhulimhen-Iyoha, B. I., Pooboni, S. K., & Vuppali, N. K. K. (2014). Morbidity pattern and outcome of patients admitted into a pediatric intensive care unit in India. Indian Journal of Clinical Medicine, 5, IJCM. S13902. DOI: https://doi.org/10.4137/IJCM.S13902

Butt, W., Shann, F., Tibballs, J., Williams, J., Cuddihy, L., Blewett, L., & Farley, M. (1990). Long-term outcome of children after intensive care. Critical care medicine, 18(9), 961-965. DOI: https://doi.org/10.1097/00003246-199009000-00011

Carpenter, T., Dobyns, E., & Lane, J. (2003). Current Pediatric Diagnosis and Treatment: Singapore: McGraw Hill.

Choi, K., Ng, D., Wong, S., Kwok, K., Chow, P., Chan, C., & Ho, J. (2005). Assessment of the Pediatric Index of Mortality (PIM) and the Pediatric Risk of Mortality (PRISM) III score for prediction of mortality in a paediatric intensive care unit in Hong Kong. Hong Kong Med J, 11(2), 97-103.

Costa, G. A., Delgado, A. F., Ferraro, A., & Okay, T. S. (2010). Application of the pediatric risk of mortality (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit. Clinics, 65(11), 1087-1092. DOI: https://doi.org/10.1590/S1807-59322010001100005

Curtis, J. R., Cook, D. J., Wall, R. J., Angus, D. C., Bion, J., Kacmarek, R., . . . Mitchell, P. H. (2006). Intensive care unit quality improvement: a “how-to” guide for the interdisciplinary team. Critical care medicine, 34(1), 211-218. DOI: https://doi.org/10.1097/01.CCM.0000190617.76104.AC

El‐Nawawy, A. (2003). Evaluation of the outcome of patients admitted to the pediatric intensive care unit in Alexandria using the pediatric risk of mortality (PRISM) score. Journal of tropical pediatrics, 49(2), 109-114. DOI: https://doi.org/10.1093/tropej/49.2.109

Frankel, R. (2004). Nelson textbook of pediatrics. Pediatric critical care, 268-269.

Gemke, R., Bonsel, G. J., & van Vught, A. J. (1995). Long-term survival and state of health after paediatric intensive care. Archives of disease in childhood, 73(3), 196-201. DOI: https://doi.org/10.1136/adc.73.3.196

Haque, A., & Bano, S. (2009). Clinical profile and outcome in a paediatric intensive care unit in Pakistan. Journal of the College of Physicians and Surgeons Pakistan, 19(8), 534.

Hoque, M. S., Masud, M. A. H., & Ahmed, A. N. U. (2012). Admission pattern and outcome in a paediatric intensive care unit of a tertiary care paediatric hospital in Bangladesh–A two-year analysis.

Isamade, E., Yiltok, S., Uba, A., Isamade, E., & Daru, P. (2007). Intensive care unit admissions in the Jos University Teaching Hospital. Nigerian journal of clinical practice, 10(2), 156-161.

Jaimovich, D. (2004). The Committee on Hospital Care and Section on Critical Care, Guidance for Clinical Rendering Pediatric Care, Admission and Discharge Guidelines for the Pediatric Patient Requering Intermediate Care, American Academy of Pediatrics. Pediatrics, 113, 1430-1433. DOI: https://doi.org/10.1542/peds.113.5.1430

Khilnani, P., Sarma, D., Singh, R., Uttam, R., Rajdev, S., Makkar, A., & Kaur, J. (2004). Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Apollo Medicine, 1(2), 161-166. DOI: https://doi.org/10.1016/S0976-0016(11)60242-1

Klem, S. A., Pollack, M. M., & Getson, P. R. (1990). Cost, resource utilization, and severity of illness in intensive care. The Journal of pediatrics, 116(2), 231-237. DOI: https://doi.org/10.1016/S0022-3476(05)82879-3

Luce, J. M., & Rubenfeld, G. D. (2002). Can health care costs be reduced by limiting intensive care at the end of life? American journal of respiratory and critical care medicine, 165(6), 750-754. DOI: https://doi.org/10.1164/ajrccm.165.6.2109045

Mehta, A., Rosenthal, V., Mehta, Y., Chakravarthy, M., Todi, S., Sen, N., . . . Kapoor, P. (2007). Device-associated nosocomial infection rates in intensive care units of seven Indian cities. Findings of the International Nosocomial Infection Control Consortium (INICC). Journal of Hospital Infection, 67(2), 168-174. DOI: https://doi.org/10.1016/j.jhin.2007.07.008

Oke, D. (2001). Medical admission into the intensive care unit (ICU) of the Lagos University Teaching Hospital. The Nigerian postgraduate medical journal, 8(4), 179-182.

Parkash, J., & Das, N. (2005). Pattern of admissions to neonatal unit. Journal of the College of Physicians and Surgeons—Pakistan: JCPSP, 15(6), 341-344.

Rady, H. I. (2014). Profile of patients admitted to pediatric intensive care unit, Cairo University Hospital: 1-year study. Ain-Shams Journal of Anaesthesiology, 7(4), 500. DOI: https://doi.org/10.4103/1687-7934.145680

Shah, G. S., Shah, B. K., Thapa, A., Shah, L., & Mishra, O. (2014). Admission patterns and outcome in a pediatric intensive care unit in Nepal. British Journal of Medicine and Medical Research, 4(30), 4939. DOI: https://doi.org/10.9734/BJMMR/2014/10318

Sharma, U., Sharma, A., Hanspal, R., Singh, J., Singh, R., & Rana, S. (2012). Epidemiological Study of Morbidity Pattern of Critically Ill Children Admitted in Child Intensive Therapy Unit.

Singhal, D., Kumar, N., Puliyel, J., Singh, S., & Srinivas, V. (2001). Prediction of mortality by application of PRISM score in intensive care unit. Indian pediatrics, 38(7), 714-720.

Watters, D. (1993). Caring for the critically ill. Africa Health, 16(1), 22-24.

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Published

2018-12-31

How to Cite

Gresh, H., & Othman, R. . (2018). Admission Patterns and Outcome in a Pediatric Intensive Care Unit at Tobruk Hospital. Al-Mukhtar Journal of Sciences, 33(4), 298–305. https://doi.org/10.54172/mjsc.v33i4.293

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