General Characteristics and Mortality Risk Factors in Critically Ill Pediatric Patients in a Pediatric Intensive Care Unit

Abstract

Objective: This study aims to evaluate the general characteristics of critically ill pediatric patients treated and monitored in our pediatric intensive care unit (PICU) and to examine the factors influencing mortality. Materials and Methods: We included all critically ill pediatric patients treated and monitored in our PICU from January 2020 to November 2023. Patients were categorized into two groups: Survivors and non-survivors, with various comparisons made between these groups. Results: The study included 1,035 patients, with a male predominance (56%). The median age was 37 months. The average PICU stay was 10.6±28.1 days. Mortality was 6.8%, with non-survivors having significantly higher Pediatric Risk of Mortality III (PRISM-III) scores (19 vs. 1, p<0.001) and longer PICU stays (13 vs. 4 days, p<0.001). Mortality increased with the number of affected systems (p<0.001). Tracheostomy and central vein catheter placement rates were higher among non-survivors (p=0.006 and p<0.001, respectively). Inotropic support and blood transfusions were significantly higher in non-survivors (p<0.001 and p<0.001). The PRISM-III score had a sensitivity of 82.6% and a specificity of 88.9% for predicting mortality at a cutoff of 10. Regression analysis showed that an increased number of affected systems (p<0.001), need for tracheostomy (p=0.023), inotropic support (p=0.043), and higher PRISM-III scores (p=0.025) were significant mortality predictors. Conclusion: The need for tracheostomy, initiation of inotropic therapy, and the number of failing organ systems were identified as factors influencing mortality in critically ill pediatric patients. In addition, the PRISM-III score proved effective in predicting mortality in this cohort.