[Risk factors of death in children with diarrhea and shock admitted to the intensive care unit].
BACKGROUND
Describe clinical and epidemiological characteristics of pediatric patients diagnosed with acute diarrhea and shock, admitted to the pediatric intensive care unit, in order to compare the evolution of clinical data between the survival and non-survival groups, thereby identifying the risk factors of death.


METHODS
In the Pediatric Intensive Care Unit of the Clinical Hospital at the State University of Campinas (UNICAMP), a non-controlled, descriptive and retrospective study was carried out from February 1994 to January 1998 The epidemiological and clinical/evolution data were analyzed and the groups of those who survived (56) and did not survive (15) were compared. For continuous variables, the Chi-Square test was used and for categorical variables, the Fisher's Exact test, for values lower than five.


RESULTS
Seventy one children aged from 0.4 to 13.9 months were admitted, 15 of them died (21.2%). Low birth weight was found in 18.1% and the mean breast-feeding time was 1.1 months. The average length of stay was 5.6 days. 52/71 children needed mechanical ventilation, use of vasoactive drugs and sodium bicarbonate was necessary in 23/71 and 15/71, respectively. 93% of children were given antibiotics. The use of sodium bicarbonate, vasoactive drugs and mechanical ventilation showed an association with risk of death, but only vasoactive drugs (OR=18.56) and an age less than 3 months (OR=0.10) showed a statistically significant difference in multivariate analysis.


CONCLUSIONS
Acute diarrhea and shock occurred mainly in children under 3 months of age with a severe clinical/laboratorial condition. During clinical evolution, the high risk of death was related to the use of vasoactive drugs, a support therapy used in critical patients.
Brandão
Marcelo B
MB
Hospital de Clínicas e Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Rua Aristides Lobo 7890, Cidade Universitária, Camoinas, São Paulo (SP), CEP 13083-060, Brazil. mbbrandao@globo.com
Lopes
Carlos E
CE
Morcillo
André M
AM
Baracat
Emílio C E
EC
D000208:Acute Disease; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D003967:Diarrhea / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D017678:Sex Distribution; D012769:Shock / Q000401:mortality*