Analysis of Mortality in PICU of a Tertiary Care Teaching Hospital

Background: Paediatric critical care medicine is a challenging contemporary subspecialty. The development of paediatric intensive care has contributed to the improved survival of critically ill children. Aim: To study and analyse the deaths occurring over a period of one year in a Pediatric Intensive Care Unit (PICU) of a tertiary care teaching hospital. Methods: A prospective observational cohort study of deaths in PICU was conducted over a period of one year. Data collected was demographic profile, co morbidities, length of stay, diagnosis, ICU therapies like use of inotropes and mechanical ventilation (MV). Results: Out of 10, 186 patients admitted in Department of Pediatrics in the above time period, 930 patients required Intensive care support.322 patients succumbed to death, having a high mortality rate of 34.6 %. Maximum number of death was observed in the age group of 1 month to 1 year accounting for 32.9 % of deaths. The highest mortality in PICU was due to septicemia followed by meningoencephalitis. Among respiratory causes, ARDS and Pneumonia were the major causes. Among cardiac causes, Congenital Cyanotic Heart Disease is the leading cause of death. Other causes of death were hepatic encephalopathy and acute and chronic renal failure. Conclusion: By their very virtue, ICUs are resource intensive with respect to both technology and the need for skilled health care providers. A large percentage of hospital costs are attributed to the ICU. As the cost of health care increases, the need to manage the resources of the ICU as efficiently and effectively as possible increases in importance as well.