The influence of chronic health conditions on susceptibility to severe acute illness of children treated in PICU.
OBJECTIVE
Our study aimed to assess differences in the susceptibility to severe acute illness in children with and without chronic health conditions treated in a pediatric intensive care unit (PICU).


METHODS
Data on age, gender, need for ventilator support, length of stay, as well as other parameters for the Paediatric Index of Mortality (PIM2) score were collected. Data were analyzed and compared across three patient groups: those with a neurodevelopmental disability, those with a chronic condition other than a neurodevelopmental disability, and those with no chronic condition. Reasons for admission of patients were classified according to the Australia and New Zealand Paediatric Intensive Care Registry (ANZPIC Registry) diagnostic codes. In the multidisciplinary, seven-bed, level I PICU of the Split University Hospital, the admission data were collected prospectively for 591 consecutively admitted patients aged<or=18 years.


RESULTS
Patients with a neurodevelopmental disability had a significantly higher rate of respiratory-related admissions compared to patients with other chronic health conditions and those with no chronic condition (chi2=33.72, P<0.001). There was a significant difference in the age at admission (f=6.04, P=0.003), median length of stay (f=7.94, P<0.001), need for ventilation during the first hour of admission (chi2=14.74, P<0.001) and PICU mortality (chi2=9.91, P=0.007) of patients with neurodevelopmental disabilities, compared to the other two groups of patients.


CONCLUSIONS
Children with neurodevelopmental disabilities are more susceptible to acute illness compared to children with other chronic health conditions and those with no chronic condition.
Pediatric Intensive Care Unit, Department of Pediatrics, Split University Hospital, Spinèieva 1, 21000, Split, Croatia. julije.mestrovic@st.t-com.hr
Julije
J
Mestrović
Goran
G
Kardum
Branka
B
Polić
Marija
M
Mestrović
Josko
J
Markić
Alan
A
Sustić
Vjekoslav
V
Krzelj
D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology*; D017523:Croatia / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D004198:Disease Susceptibility; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008171:Lung Diseases / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012720:Severity of Illness Index