Abstract
Objective: To assess the condition at admission, survival, and prognosis of patients at the Intensive Care Unit of the IESN.
Design: Longitudinal prospective study. Setting: Pediatric intensive care unit in an institute specialized in children. Patients: 819 patients between 3 and 17.9 years old consecutively admitted during a 42 month-period. Material and Methods: At admission: demographic data, vital and clinical signs; laboratory analysis; major diagnostic categories and related morbidities; and primary clinical specialty; main procedures; PRISM, TISS-28; Predicted Rate of Mortality and the Time of Nurse's Care (TNC). Construction of survival table and curves for 30 days in relation to time of nurse's care required by the patients. Efficiency was determined by Pollack's criteria of mortality risk >1% and / or at least the administration of one ICU-dependent therapy.
Results: Mean age was 109.4 + 1.7 months, length of stay 9.2 + 18.7 days, and overall mortality rate 16.2% (n=133). 60% required mechanical ventilation. General Survival for 30 days was 43%. Main factors associated to mortality: PRISM (p < 0.001), TNC (p < 0.007), mechanical ventilation (p < 0.001), gender (p=0.016), primary clinical specialty (p=0.033), and major diagnostic category (p=0.035). The survival curve for time of nurse's care showed: survival was greater in patients who required less than 266 minutes (4.4 hours) of nurse's care and mortality was greater in patients requiring more than 349 minutes (5.8 hours) of care. 688 (84%) admissions were efficient. Mean values: PRISM = 10.77 + 6.85, TNC = 279.98 + 104.5 minutes, and TISS-28 = 26.42 + 9.83.
Conclusions: General survival after a follow-up of 30 days was less than 50%. Survival curves related to time of nurse's care showed that patients that required less time for nurse's care had a greater probability of survival; patients who required greater care had a greater probability of mortality. Main factors associated with mortality were high PRISM score and greater need for nursery care. The efficiency at our unit met the standard set forth in the American and the European study.
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Nakachi, G., Cieza, J. & Shimabuku, A. 21 Relation of Survival and Time of Care of Nurse in Critically Ill Children. Pediatr Res 57, 923 (2005). https://doi.org/10.1203/00006450-200506000-00049
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DOI: https://doi.org/10.1203/00006450-200506000-00049