Incidence and Mortality Trends in Critically Ill Children: A Korean Population-Based Study

被引:1
作者
Choi, Jaeyoung [1 ]
Park, Esther [2 ]
Choi, Ah Young [3 ]
Son, Meong Hi [4 ]
Cho, Joongbum [1 ,5 ]
机构
[1] Sungkyunkwan Univ Sch Med, Samsung Med Ctr, Dept Crit Care Med, Seoul, South Korea
[2] Jeonbuk Natl Univ Childrens Hosp, Dept Pediat, Jeonju, South Korea
[3] Chungnam Natl Univ Hosp, Dept Pediat, Daejeon, South Korea
[4] Sungkyunkwan Univ Sch Med, Samsung Med Ctr, Dept Pediat, Seoul, South Korea
[5] Sungkyunkwan Univ Sch Med, Samsung Med Ctr, Dept Crit Care Med, 81 Irwon Ro, Seoul, South Korea
关键词
Pediatrics; Critical Care; Trends; Epidemiology; In-hospital Mortality; National Health Insurance; PEDIATRIC INTENSIVE-CARE; LENGTH-OF-STAY; UNIT; PATTERNS; OUTCOMES; IMPACT;
D O I
10.3346/jkms.2023.38.e178
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Monitoring mortality trends can help design ways to improve survival, but observation of national mortality trends in critically ill children is lacking for the Korean populationMethods: We analyzed the incidence and mortality trends of children younger than 18 years admitted to an intensive care unit (ICU) from 2012 to 2018 using the Korean National Health Insurance database. Neonates and neonatal ICU admissions were excluded. Multivariable logistic regression analyses were performed to estimate the odds ratio of in-hospital mortality according to admission year. Trends in incidence and in-hospital mortality of subgroups according to admission department, age, presence of intensivists, admissions to pediatric ICU, mechanical ventilation, and use of vasopressors were evaluated.Results: The overall mortality of critically ill children was 4.4%. There was a significant decrease in mortality from 5.5% in 2012 to 4.1% in 2018 (P for trend < 0.001). The incidence of ICU admission in children remained around 8.5/10,000 population years (P for trend = 0.069). In-hospital mortality decreased by 9.2% yearly in adjusted analysis (P < 0.001). The presence of dedicated intensivists (P for trend < 0.001, mortality decrease from 5.7% to 4.0%) and admission to pediatric ICU (P for trend < 0.001, mortality decrease from 5.0% to 3.2%) were associated with significant decreasing trends in mortality.Conclusion: Mortality among critically ill children improved during the study period, and the improving trend was prominent in children with high treatment requirements. Varying mortality trends, according to ICU organizations, highlight that advances in medical knowledge should be supported structurally.
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页数:11
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