Outcome of pediatric intensive care at six centers in Mexico and Ecuador. Earle Jr., M., Martinez Natera, O., Zaslavsky, A., Quinones, E., Carrillo, H., Garcia Gonzalez, E., Torres, A., Marquez, M., Garcia-Montes, J., Zavala, I., Garcia-Davila, R., & Todres, I. Critical Care Medicine, 25(9):1462–1467, 1997.
Outcome of pediatric intensive care at six centers in Mexico and Ecuador [link]Paper  doi  abstract   bibtex   
Objective: To improve understanding of the causes of morbidity and mortality among critically ill children in the countries studied. Design: Survey of hospital records between 1992 and 1994. Setting: Six pediatric intensive care units (ICUs) (four ICUs in Mexico City and two ICUs in Ecuador). Patients: Consecutive patients (n = 1,061) admitted to the units studied. Interventions: None. Measurements and Main Results: The mortality rate for low-risk patients (Pediatric Risk of Mortality [PRISM] score of ≤10, n = 701) was more than four times the rate predicted by the PRISM score (8.1% vs. 1.8%, p \textless .001), with an additional 11.3% of this group incurring major morbidity. The mortality rate for moderate-risk patients (PRISM scores of 11 to 20, n = 232) was more than twice predicted (28% vs. 12%, p \textless .001). For low-risk patients, death was significantly associated with tracheal intubation, central venous cannulation, pneumonia, age of \textless2 months, use of more than two antibiotics, and nonsurgical diagnosis (after controlling for PRISM score). Central venous cannulation and tracheal intubation in the lower-risk groups were performed more commonly in units in Mexico than in one comparison unit in the United States (p \textless .001). Conclusions: For six pediatric ICUs in Mexico and Ecuador, mortality was significantly higher than predicted among lower-risk patients. Tracheal intubation, central catheters, pneumonia, sepsis, and nonsurgical status were associated with poor outcome for low-risk groups. We speculate that reducing the use of invasive central catheters and endotracheal intubation for lower-risk patients, coupled with improved infection control, could lower mortality rates in the population studied.
@article{earle_jr_outcome_1997,
	title = {Outcome of pediatric intensive care at six centers in {Mexico} and {Ecuador}},
	volume = {25},
	issn = {00903493 (ISSN)},
	url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030820306&doi=10.1097%2f00003246-199709000-00011&partnerID=40&md5=a144566e51d1b45786759e25d32b16be},
	doi = {10.1097/00003246-199709000-00011},
	abstract = {Objective: To improve understanding of the causes of morbidity and mortality among critically ill children in the countries studied. Design: Survey of hospital records between 1992 and 1994. Setting: Six pediatric intensive care units (ICUs) (four ICUs in Mexico City and two ICUs in Ecuador). Patients: Consecutive patients (n = 1,061) admitted to the units studied. Interventions: None. Measurements and Main Results: The mortality rate for low-risk patients (Pediatric Risk of Mortality [PRISM] score of ≤10, n = 701) was more than four times the rate predicted by the PRISM score (8.1\% vs. 1.8\%, p {\textless} .001), with an additional 11.3\% of this group incurring major morbidity. The mortality rate for moderate-risk patients (PRISM scores of 11 to 20, n = 232) was more than twice predicted (28\% vs. 12\%, p {\textless} .001). For low-risk patients, death was significantly associated with tracheal intubation, central venous cannulation, pneumonia, age of {\textless}2 months, use of more than two antibiotics, and nonsurgical diagnosis (after controlling for PRISM score). Central venous cannulation and tracheal intubation in the lower-risk groups were performed more commonly in units in Mexico than in one comparison unit in the United States (p {\textless} .001). Conclusions: For six pediatric ICUs in Mexico and Ecuador, mortality was significantly higher than predicted among lower-risk patients. Tracheal intubation, central catheters, pneumonia, sepsis, and nonsurgical status were associated with poor outcome for low-risk groups. We speculate that reducing the use of invasive central catheters and endotracheal intubation for lower-risk patients, coupled with improved infection control, could lower mortality rates in the population studied.},
	language = {English},
	number = {9},
	journal = {Critical Care Medicine},
	author = {Earle Jr., M. and Martinez Natera, O. and Zaslavsky, A. and Quinones, E. and Carrillo, H. and Garcia Gonzalez, E. and Torres, A. and Marquez, M.P. and Garcia-Montes, J. and Zavala, I. and Garcia-Davila, R. and Todres, I.D.},
	year = {1997},
	keywords = {Child, Child, Preschool, Critical Illness, Critical care, Ecuador, Hospital Mortality, Humans, Infant, Infants, Intensive Care, Intensive Care Units, Pediatric, Latin America, Mexico, Mortality rate, Odds Ratio, Outcome Assessment (Health Care), Patient outcome assessment, Pediatric intensive care units, Predictive Value of Tests, Prospective Studies, Risk Factors, Severity of Illness Index, Severity of illness index, World health, article, cannulation, child care, ecuador, endotracheal intubation, high risk population, human, intensive care, major clinical study, medical record, mexico, mortality, multicenter study, prediction, priority journal},
	pages = {1462--1467},
}
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