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ÇOCUK YOĞUN BAKIM ÜNİTESİNE YATAN HASTALARIN KLİNİK VE DEMOGRAFİK DEĞERLENDİRİLMESİ

Year 2022, Volume: 12 Issue: 2, 276 - 280, 15.03.2022
https://doi.org/10.16899/jcm.1056822

Abstract

Amaç: Bu çalışmada Ankara Şehir Hastanesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Yoğun Bakım Ünitesi’ne (ÇYBÜ)’ne 2 yıl içinde yatan hastaların klinik ve demografik özellikleri incelenerek hangi hastalara hizmet verildiğinin ve sonuçlarının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışma Ankara Şehir Hastanesi 32 yataklı 3. basamak çocuk yoğun bakım ünitesinde yapıldı. Merkezimiz ÇYBÜ’ne 01.09.2019-01.09.2021 tarihleri arasında yatırılmış olan 1 ay ile 18 yaş arası 2280 hastanın dosya kayıtları retrospektif olarak incelendi. Yaş, cinsiyet, kronik hastalık varlığı, yoğun bakım ünitesine yatırılma nedeni, yatış süresi, solunum destek cihazına bağlanma durumu ve süresi, mortalite oranları değerlendirildi.
Bulgular: Olguların ortalama yaşları 5,16±5,12 yıl ve ortalama yoğun bakım yatış süreleri 12,47±20,16 gündü. ÇYBÜ’ne Bronşiolit, Sepsis, Pnomoni, Travma, Konjenital kalp Hastalığı, satatus epileptikus, Hematolojik hastalıklar, onkolojik hastalıklar, Diabetik ketoasidoz, Metabolik hastalıklar en sık yatış nedeni olarak bulundu. En fazla altta yatan hastalıklar Norolojik, Solunumsal, Hematolojik, Kardiyolojik, Endokrinolojik, Nefrolojik, Gastrointestinal sistem (GIS) hastalıkları, onkolojik hastalıklar, Metabolik hastalıklar gözlendi. Hastaların %10.8’u kaybedildi. Ölen hastalarda altta yatan onkolojik, hematolojik hastalıklar ve immün yetmezliği olan hastalarda enfeksiyona duyarlılıklarının fazla olması, yatış süresinin ve mekanik ventilatörde kalış süresinin uzun olması sağ kalanlara göre istatistiksel olarak anlamlı derecede fazla bulundu.
Sonuç: Çocuk yoğun bakıma kabul edilen hasta profili her geçen gün artmaktadır. Bütün hasta gruplarında multidisipliner olarak yaklaştıkça mortalitede önemli oranda azalma görülmüştür. Hastaların bir çoğunda altta yatan kronik bir hastalık olduğu ve bu durumun mortalite ile ilişkili olduğu gözlendi.

Supporting Institution

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Project Number

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References

  • 1. Downes JJ. The historical evolution, current status, and prospective development of pediatric critical care. Crit Care Clin 1992;8(1),1-22.
  • 2. Randolph AG, Gonzales CA, Cortellini L, Yeh TS. Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr 2004;144(6):792-8.
  • 3. Köroğlu TF. Türkiye Pediatrik Yoğun Bakım Anketi 2005.
  • 4. Dünser MW, Baelani I, Ganbold L. A review and analysis of intensive care medicine in the least developed countries. Crit Care Med 2006;34:1234–42.
  • 5. Konca Ç, Tekin M, Karakoç F, Turgut M. Çocuk Yoğun Bakım Ünitesinde Yatan 770 Hastanın Değerlendirilmesi: Tek Merkez Deneyimi. Türkiye Çocuk Hastalıkları Dergisi 2015;9:90-95.
  • 6. Orhan MF, Yakut İH, İkiz MA. Çocuk yoğun bakım ünitesinde 2 yıl içinde yatan 938 olgumuzun değerlendirilmesi. Türkiye Çocuk Hast Derg 2012;6:228-31. 7. Porto JP, Mantese OC, Arantes A et al. Nosocomial infections in a pediatric intensive care unit of a developing country:NHSN surveillance. Rev Soc Bras Med Trop 2012;45(4):475-9.
  • 8. Arias Y, Taylor DS, Marcin JP. Association between evening admissions and higher mortality rates in the pediatric intensive care unit. Pediatrics 2004;113(6):e530–4.
  • 9. Khilnani P, Sarma D, Singh R et al. Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Indian J Pediatr 2004;71(7):587-91.
  • 10. Kotsakis A, Lobos AT, Parshuram C et al. Ontario Pediatric Critical Care Response Team Collaborative. Implementation of a multicenter rapid response system in pediatric academic hospitals is effective. Pediatrics 2011;128(1):72–8.
  • 11. Odetola FO, Rosenberg AL, Davis MM et al. Do outcomes vary according to the source of admission to the pediatric intensive care unit? Pediatr Crit Care Med 2008;9(1):20–5.
  • 12. Shann F, A Argent. Pediatric intensive care in developing countries, in Pediatric Critical Care, B.P. Fuhrman and J.J. Zimmerman, Editors. 2006, C.V. Mosby: Philadelphia.
  • 13. Tutanç M, Arıca V, Başarslan F, Karcıoğlu M, Yel S, Kaplan M, ve ark. Çocuk yoğun bakım ünitesine yatan hastaların değerlendirilmesi. Düzce Tıp Dergisi 2011;13:18-22.
  • 14. Embu HY, Yiltok SJ, Isamade ES et al. Paediatric admissions and outcome in a general intensive care unit. Afr J Paediatr Surg 2011;8:57–61.
  • 15. Salamati P, Talaee S, Eghbalkhah A et al. Validation of pediatric index of mortality-2 scoring system in a single pediatric intensive care unit in Iran. Iran J Pediatr 2012;22:481–6.
  • 16. Durasnel P, Gallet de Santerre P, Merzouki D et al. Should mechanical ventilation be used in ICU patients in developing countries? Med Trop (Mars) 2005;65:537–42.
  • 17. Robison JA, Ahmad ZP, Nosek CA et al. Decreased pediatric hospital mortality after an intervention to improve emergency care in Lilongwe. Malawi Pediatr 2012;130:e676–82.
  • 18. Kawaza K, Machen HE, Brown J et al. Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi. PLoS One 2014;9:e86327.
  • 19. Cavallazzi R, Marik PE, Hirani A et al. Association between time of admission to the ICU and mortality. Chest 2010;138:68–75.

CLINICAL AND DEMOGRAPHIC EVALUATION OF PATIENTS ADMITTED TO THE PEDIATRIC INTENSIVE CARE UNIT

Year 2022, Volume: 12 Issue: 2, 276 - 280, 15.03.2022
https://doi.org/10.16899/jcm.1056822

Abstract

Purpose: This study aimed to evaluate the patients who received health services in the pediatric intensive care unit (PICU) of Ankara City Hospital’s Pediatrics Department in a 2-year period and the outcomes of these cases by examining their clinical and demographic characteristics.
Materials and Methods: This retrospective study was carried out in the 32-bed tertiary PICU of Ankara City Hospital. The records of 2280 patients between the ages of 1 month and 18 years who were hospitalized in the PICU between September 1, 2019, and September 1, 2021, were retrospectively analyzed. Age, sex, presence of chronic disease, reason for hospitalization in the intensive care unit, length of stay, status and duration of respiratory support, and mortality rates were evaluated.
Results: The mean age of the patients was 5.16±5.12 years and the mean PICU stay was 12.47±20.16 days. Bronchiolitis, sepsis, pneumonia, trauma, congenital heart disease, status epilepticus, hematological diseases, oncological diseases, diabetic ketoacidosis, and metabolic diseases were found to be the most common reasons for hospitalization in the PICU. The most frequent underlying diseases were neurological, respiratory, hematological, cardiological, endocrinological, nephrological, gastrointestinal system, oncological, and metabolic diseases. The mortality rate of these patients was 10.8%. Underlying oncological or hematological diseases and immunodeficiency, higher susceptibility to infection, longer hospital stay, and longer duration of mechanical ventilation were found to be statistically significantly higher in deceased patients compared to survivors.
Conclusion: The profile of patients admitted to PICUs is expanding day by day. A significant decrease in mortality was observed in all patient groups as a multidisciplinary approach was implemented. It was also observed that most of the patients had an underlying chronic disease and this condition was associated with mortality.

Project Number

-

References

  • 1. Downes JJ. The historical evolution, current status, and prospective development of pediatric critical care. Crit Care Clin 1992;8(1),1-22.
  • 2. Randolph AG, Gonzales CA, Cortellini L, Yeh TS. Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr 2004;144(6):792-8.
  • 3. Köroğlu TF. Türkiye Pediatrik Yoğun Bakım Anketi 2005.
  • 4. Dünser MW, Baelani I, Ganbold L. A review and analysis of intensive care medicine in the least developed countries. Crit Care Med 2006;34:1234–42.
  • 5. Konca Ç, Tekin M, Karakoç F, Turgut M. Çocuk Yoğun Bakım Ünitesinde Yatan 770 Hastanın Değerlendirilmesi: Tek Merkez Deneyimi. Türkiye Çocuk Hastalıkları Dergisi 2015;9:90-95.
  • 6. Orhan MF, Yakut İH, İkiz MA. Çocuk yoğun bakım ünitesinde 2 yıl içinde yatan 938 olgumuzun değerlendirilmesi. Türkiye Çocuk Hast Derg 2012;6:228-31. 7. Porto JP, Mantese OC, Arantes A et al. Nosocomial infections in a pediatric intensive care unit of a developing country:NHSN surveillance. Rev Soc Bras Med Trop 2012;45(4):475-9.
  • 8. Arias Y, Taylor DS, Marcin JP. Association between evening admissions and higher mortality rates in the pediatric intensive care unit. Pediatrics 2004;113(6):e530–4.
  • 9. Khilnani P, Sarma D, Singh R et al. Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Indian J Pediatr 2004;71(7):587-91.
  • 10. Kotsakis A, Lobos AT, Parshuram C et al. Ontario Pediatric Critical Care Response Team Collaborative. Implementation of a multicenter rapid response system in pediatric academic hospitals is effective. Pediatrics 2011;128(1):72–8.
  • 11. Odetola FO, Rosenberg AL, Davis MM et al. Do outcomes vary according to the source of admission to the pediatric intensive care unit? Pediatr Crit Care Med 2008;9(1):20–5.
  • 12. Shann F, A Argent. Pediatric intensive care in developing countries, in Pediatric Critical Care, B.P. Fuhrman and J.J. Zimmerman, Editors. 2006, C.V. Mosby: Philadelphia.
  • 13. Tutanç M, Arıca V, Başarslan F, Karcıoğlu M, Yel S, Kaplan M, ve ark. Çocuk yoğun bakım ünitesine yatan hastaların değerlendirilmesi. Düzce Tıp Dergisi 2011;13:18-22.
  • 14. Embu HY, Yiltok SJ, Isamade ES et al. Paediatric admissions and outcome in a general intensive care unit. Afr J Paediatr Surg 2011;8:57–61.
  • 15. Salamati P, Talaee S, Eghbalkhah A et al. Validation of pediatric index of mortality-2 scoring system in a single pediatric intensive care unit in Iran. Iran J Pediatr 2012;22:481–6.
  • 16. Durasnel P, Gallet de Santerre P, Merzouki D et al. Should mechanical ventilation be used in ICU patients in developing countries? Med Trop (Mars) 2005;65:537–42.
  • 17. Robison JA, Ahmad ZP, Nosek CA et al. Decreased pediatric hospital mortality after an intervention to improve emergency care in Lilongwe. Malawi Pediatr 2012;130:e676–82.
  • 18. Kawaza K, Machen HE, Brown J et al. Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi. PLoS One 2014;9:e86327.
  • 19. Cavallazzi R, Marik PE, Hirani A et al. Association between time of admission to the ICU and mortality. Chest 2010;138:68–75.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Oktay Perk 0000-0002-2586-5954

Project Number -
Early Pub Date January 1, 2022
Publication Date March 15, 2022
Acceptance Date March 14, 2022
Published in Issue Year 2022 Volume: 12 Issue: 2

Cite

AMA Perk O. CLINICAL AND DEMOGRAPHIC EVALUATION OF PATIENTS ADMITTED TO THE PEDIATRIC INTENSIVE CARE UNIT. J Contemp Med. March 2022;12(2):276-280. doi:10.16899/jcm.1056822