Influence of different admission sources on the outcome of children in pediatric intensive care unit / 中国小儿急救医学

ABSTRACT

Objective:To explore the relationship between different admission sources and outcomes at children in pediatric intensive care unit(PICU).Methods:The clinical data of children admitted to PICU of Henan Provincial People′s Hospital from January 1, 2021 to December 31, 2021 were collected.The children were divided into emergency group, outpatient group, ward transfer group and out-hospital transfer group according to different admission sources, and the influence of different admission sources on the outcome of children was analyzed.Results:A total of 413 children were included in the study.There were 141 cases(34.14%)in emergency group, 14 cases(3.39%)in outpatient group, 115 cases(27.85%)in ward transfer group and 143 cases(34.62%)in out-hospital transfer group.There were significant differences among the four groups in terms of age, length of hospital stay, PCIS score, type of disease, duration of mechanical ventilation and outcome of children( P<0.05). There was no significant difference in gender among the four groups( P=0.328). Among the 143 children of out-hospital transfer group, 92 cases(64.3%)were admitted during the day and 51 cases(35.7%)were admitted in the night.There was no significant difference in age, gender, duration of mechanical ventilation, PCIS score, length of hospital stay and outcome of children between two groups( P>0.05). The independent risk factors for mortality of children in out-hospital transfer group were length of hospital stay( OR=0.717, 95% CI 0.582-0.883, P=0.002), gender( OR=13.185, 95% CI 2.044-85.061, P=0.007), duration of mechanical ventilation>1 day( OR=23.524, 95% CI 3.294-168.026, P=0.002)and PCIS score≤80( OR=6.000, 95% CI 1.637-21.985, P=0.007). Conclusion:PICU children in our hospital mainly come from emergency, ward transfer and out-hospital transfer.The patients transferred from other hospitals were the most critically ill and had the worst outcome, suggesting that we need to develop and popularize referral standards for critically ill children and establish a transport system so that children can receive timely referral and effective treatment, so as to reduce the risk of death of referred children as far as possible.