Outcome of pediatric intensive care at six centers in Mexico and Ecuador.
To improve understanding of the causes of morbidity and mortality among critically ill children in the countries studied.
Survey of hospital records between 1992 and 1994.
Six pediatric intensive care units (ICUs) (four ICUs in Mexico City and two ICUs in Ecuador).
Consecutive patients (n=1,061) admitted to the units studied.
Measurements and Main Results
The mortality rate for low-risk patients (Pediatric Risk of Mortality [PRISM] score of ¾10, n=701) was more than four times the rate predicted by the PRISM score (8.1% vs. 1.8%, p<. 001), with an additional 11.3% of this group incurring major morbidity.
The mortality rate for moderate-risk patients (PRISM scores of 11 to 20, n=232) was more than twice predicted (28% vs. 12%, p<. 001).
For low-risk patients, death was significantly associated with tracheal intubation, central venous cannulation, pneumonia, age of<2 months, use of more than two antibiotics, and nonsurgical diagnosis (after controlling for PRISM score).
Central venous cannulation and tracheal intubation in the lower-risk groups were performed more commonly in units in Mexico than in one comparison unit in the United States (p<. 001), Conclusions : For six pediatric ICUs in Mexico and Ecuador, mortality was significantly higher than predicted among lower-risk patients. (...)
Mots-clés Pascal : Unité soin intensif, Hôpital, Mexique, Amérique Centrale, Amérique, Equateur, Amérique du Sud, Etiologie, Morbidité, Mortalité, Enfant, Homme, Pronostic
Mots-clés Pascal anglais : Intensive care unit, Hospital, Mexico, Central America, America, Ecuador, South America, Etiology, Morbidity, Mortality, Child, Human, Prognosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0472452
Code Inist : 002B27B14C. Création : 03/02/1998.