Incidence and Risk Factors of Perioperative Mortality in Pediatric ICU Patients.

Background: There is a limited data of pediatric patients who presented to the intensive care unit (ICU) and undergo procedures under general anesthesia. The primary objective of this study was to evaluate the mortality of this population and assess the risk factors associated with mortality.

Methods: Retrospective study of electronic medical records of pediatric patients who admitted to medical/surgical ICU and underwent produces under general anesthesia during the same ICU admission was performed. Incidence of mortality was obtained and risk factors associated with these mortalities were examined using Univariable logistic regression analysis.

Results: The mortality of pediatric patients who were admitted to the ICU and underwent procedures under general anesthesia was 12.6%, while the mortalities of patients without procedures under general anesthesia and patients who admitted to ICU for postoperative management were 3.5% and 0.4%, respectively. Higher ASA class, emergency cases, higher ventilator support, more inotrope requirement, positive microbe in blood stream, blood transfusion requirement, and general surgery or hematological procedures were highly associated with mortalities. Among them, positive blood stream infection was highest odds ratio (102.00, 95% confidence interval 9.78-1064.09). The profile of patients with positive blood stream infection showed that most of them had underlying immunological/hematological disorders.

Conclusion: In our institution, pediatric patients who admitted to the ICU and underwent procedures under general anesthesia demonstrated the highest mortality among other patients who admitted to ICU. Risk factor analysis demonstrated that patients with positive blood stream infection had highest odds ratio, and were highly associated with immunological/ hematological disorders.