Clinical Profile of Children Admitted in a General ICU and Outcome at The University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Background: Admission of children for intensive care results from different causes and has varying outcomes. 

Objectives: The pattern of admissions and outcomes in children admitted between January 2021 - October 2022, at the intensive care unit (ICU) of UPTH was assessed in a retrospective study. 

Methods: Data on demography, clinical characteristics and outcomes of admission of children between one month – 17years old, admitted in the ICU during the study period were collected, using records from patient’s folders and intensive care registers. SPSS v.25 was used for analysis and results presented as frequencies and percentages. 

Results: From a total of 430 patients admitted, children were 47(11.0%) with mean age 7.0 ± 5.5yrs, and M:F ratio 1.9:1. Admissions were for postoperative care [(21/45.0%)], neurological diseases [11(23.0%)], respiratory distress and TBI [(6(13.0% each)] and neuromuscular diseases [3(6.0%)]. Admitting specialties were paediatric respiratory 6(12.8%), neurology 12(25.5%) and neurosurgical teams for nonoperative care 8(17.0%), and surgical specialties for critical postoperative care 21(44.7%). Postoperative patients were admitted following general paediatric 14(29.8%), cardiac and oral maxillofacial surgeries 2(4.3%) each and others 3(6.3%) for postoperative care 21(44.7%), low GCS  15(31.9%) and cardiorespiratory support 11(23.4%). Complications were severe brain injuries 17(36.2%), severe haemorrhage 9(19.1%), respiratory failure 8(17.0%), sepsis 7(14.8%) and electrolyte imbalance 2(4.3%). Mean duration of stay was 5.6 ± 6.3 days, 22(46.8%) were discharged and mortality rate was 25(53.2%), majority being CNS/neuromuscular diseases (17/68.0%). 

Conclusion: Critical postoperative care was commonest indication for ICU admission in children, but mortality was highest in CNS/Neuromuscular pathologies.