All-Cause Mortality in a Pediatric Intensive Care Unit at a Teaching Hospital in Amman Jordan.

BACKGROUND: The aim of this study is to describe the main causes of admission to a general Pediatric Intensive Care Unit (PICU), as well as main causes of mortality in this population. In addition, we describe the percentage of patients who died following a failed cardiopulmonary resuscitation (CPR) vs. Do Not Resuscitate (DNR) orders METHODS: This is a retrospective cohort study with chart review of admissions and mortality cases that occurred in the pediatric intensive care unit. Mortality rates in the pediatric admissions are reported with description of demographics, diagnosis, length of stay, use of mechanical ventilation, use of vasoactive agents, preexisting comorbidities, the presence of a DNR order, and final cause of mortality. Modes of mortality were described as failed CPR or a DNR order.

RESULTS: During the period of the study there were 1523 admissions. Of those, 102 patients died with an overall mortality rate of 6.7%. Patients who died tended to be younger, and the majority (85%) had a preexisting comorbidity, with neuromuscular disease being most common. Majority of the patients who died (69%) required invasive ventilation. The most common immediate cause of mortality was respiratory disease, and the highest case fatality was among those with cardiac disease. Of those patients who died, 90% had failed CPR and 10% had a DNR order. Care was not withdrawn from any patient.

CONCLUSION: This study describes the diagnostic categories of children admitted to the PICU with respiratory disease being the most common cause of admission and mortality. The majority of children who died had an existing comorbidity and did not have a DNR order at the time of their death.