Descriptive and Clinical Characteristics of Non-Survivors in a Tertiary Pediatric Intensive Care Unit in Turkey: 6 Years of Experience

Abstract

Objectives: To identify the characteristics of non-survivors in a pediatric intensive care unit (PICU) in Turkey. Methods: This is a retrospective analysis of patients who died in a tertiary PICU over a 6year period from 2016 to 2021. Data were drawn from electronic medical records and resuscitation notes. Mode of death was categorized as failed cardiopulmonary resuscitation (F-CPR) or brain death (BD). Results: Among the 161 deaths, 136 non-survivors were included and 30.1% were younger than 1 year old. Severe pneumonia, respiratory failure and ARDS (31.6%) were the most common primary diagnoses. The most common mode of death was F-CPR (86.8%). More than half of the subjects had been admitted from pediatric emergency departments (58.1%), and more than half (53.7%) had died within 7 days in the PICU. Patients admitted from pediatric emergency departments had the lowest frequency of comorbidities (p<0.001). Severe pneumonia, respiratory failure and acute respiratory distress syndrome diagnoses were significantly more frequent in those who died after 7 days (p<0.001); whereas, septicemia, shock and multiple organ dysfunction were more common among those who died within the first day of PICU admission (p<0.001). Conclusions: It may be important to note that patients referred from wards are highly likely to have comorbidities, while those referred from pediatric emergency departments may be relatively younger. Additionally, patients with septicemia, shock or multiple organ dysfunction were more likely to die earlier (within 7 days), especially compared to those with severe pneumonia, respiratory failure or acute respiratory distress.