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Disease spectrum and prognosis of children in pediatric intensive care unit in non-epidemic areas during Corona Virus Disease 2019 epidemic period / 中国小儿急救医学
Chinese Pediatric Emergency Medicine ; (12): 955-959, 2021.
Article in Chinese | WPRIM | ID: wpr-908399
ABSTRACT

Objective:

To analyze the influence of Corona Virus Disease 2019(COVID-19) epidemic on inpatient disease spectrum, treatment methods and outcomes in pediatric intensive care unit(PICU)in non-epidemic areas.

Methods:

The clinical data of children admitted to PICU at Shengjing Hospital of China Medical University from February 1, 2019 to May 30, 2019(group Ⅰ)and from February 1, 2020 to May 30, 2020(group Ⅱ)were collected retrospectively.We analyzed the spectrum changes of infectious and non-infectious diseases, visiting time, as well as compared the diseases of various systems and accidental injuries, and the use of important treatment methods, all-cause mortality.

Results:

There were 339 cases in group Ⅰ and 208 cases in group Ⅱ.The total number of patients in group Ⅱ decreased by 38.6% compared with group Ⅰ.There was no significant difference in pediatric multiple organ dysfunction score (P-MODS)( P=0.894)between two groups within 24 hours after admission, but pediatric logistic organ dysfunction score (PELOD)-2 in group Ⅱ[1(0, 3)] was higher than that in group Ⅰ[1(0, 2)] within 24 hours after admission, with statistical difference( P=0.012). The length of hospital stay in group Ⅱ was longer than that in group Ⅰ, but there was no statistical difference.The length of hospital stay in shock group, accidental injury and poisoning group were 6(5.25, 8.25)days and 9(6, 16)days, respectively, with statistical differences( P=0.048, P=0.001). Compared with group Ⅰ, the number and ratio of infectious diseases(pneumonia, aseptic encephalitis and sepsis)in group Ⅱ decreased significantly[176(52.1%)to 93(44.5%), P=0.095]. Neuromuscular diseases aseptic encephalitis decreased from 13.2% to 7.2%; non-traumatic intracranial hemorrhage increased from 0.9% to 3.8%, with statistical difference( P=0.028, P=0.017). Compared with group Ⅰ, the number of invasive interventional therapy cases in group Ⅱ decreased significantly, among which non-invasive ventilator, plasma exchange and fiberoptic bronchoscope decreased by at least 50%, but there was no significant difference between two groups.The average time from onset to visit was 7(4, 12)days in group Ⅰ and 3(1, 6)days in group Ⅱ, with statistical difference( P=0.002). There were 16 hospital deaths in group Ⅰ, with a mortality rate of 4.7%, and 7 hospital deaths in group Ⅱ, with a mortality rate of 3.4%.There was no significant difference in the total mortality and the mortality of the main diseases causing death.

Conclusion:

The epidemic situation of Corona Virus Disease 2019 led to characteristic changes in disease spectrum of children admitted to PICU, and infectious diseases were obviously reduced.Non-infectious diseases such as trauma and poisoning were still the main causes of critically ill children.During the epidemic period, there was no obvious change in treatment, PICU admission time and all-cause mortality rate of critically ill children in non-epidemic areas, thus it could be seen that the epidemic did not have adverse effects on treatment, referral, and prognosis of critically ill children.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Pediatric Emergency Medicine Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Pediatric Emergency Medicine Year: 2021 Type: Article