RT Journal Article
SR Electronic
T1 Causes, timing, and modes of death in a tertiary pediatric intensive care unit
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1186
OP 1194
DO 10.15537/smj.2021.42.11.20210508
VO 42
IS 11
A1 Ayman Al-Eyadhy
A1 Mohamad-Hani Temsah
A1 Gamal M. Hasan
A1 Mohammed Almazyad
A1 Ali A. Alhaboob
A1 Majed Alabdulhafid
A1 Fahad Alsohime
A1 Ahmed S. Alzahrani
A1 Abdullah M. Alammari
A1 Faisal S. Abunohaiah
A1 Nawaf F. Alfawzan
A1 Suhail S. Alghamdi
YR 2021
UL http://smj.org.sa/content/42/11/1186.abstract
AB Objectives: To identify the causes, modes, and timing of death in a tertiary pediatric intensive care unit (PICU).Methods: This is a retrospective data analysis of patients older than 48 hours and younger than 15 years who died in the PICU over a 5-year period from January 2012 until December 2016 at a tertiary hospital in Riyadh, Saudi Arabia.Results: There were 101 deaths out of 2295 admissions, representing average crude mortality rate of 4.4%. Sepsis was the most common cause of death in 31 patients (30.7%), followed by lower respiratory tract infections in 19 (18.8%), and cardiac diseases in 12 (11.9%). Failed cardiopulmonary resuscitation was the most common mode of death in 51 patients (50.5%), followed by withholding life-sustaining treatment in 43 (42.6%), and brain death in 7 (6.9%). Although more deaths occurred during after hours (n=70; 69.3%), there was no significant correlation between mode of death and working hours vs. after hours (p>0.05). Among the cohort, 63 patients (62.4%) had an infection-attributed mortality, of which 43 (68.3%) were bacterial, 14 (22.2%) were viral, and 10 (15.9%) were fungal.Conclusion: Infections remain a significant cause of death in the PICU. Further improvement of prevention programs and early therapy of severe infections could lower pediatric mortality. This report highlights the need for enhancing palliative care programs. The low rate of brain death diagnoses warrants further investigation.