Luís Almeida Santos (Portugal)
Centro Hospitalar e Universitário São João Paediatrics Emergency DepartmentAuthor Of 1 Presentation
PREDICTORS OF INTENSIVE CARE UNIT ADMISSION IN PATIENTS ADMITTED IN THE PAEDIATRIC RESUSCITATION ROOM – A RETROSPECTIVE ANALYSIS
Abstract
Background and Aims
Resuscitation rooms (RR) are the mainstay of Paediatric Emergency Care. Despite this, few studies describe its patients’ conditions and prognosis. We aim to describe the most frequent motives for admission to RR and the main predictors of subsequent admittance to PICU.
Methods
Data concerning all patients under 18 years of age admitted to a tertiary hospital’s RR during a four-year period was retrospectively collected and analysed.
Results
During this period, 363 patients were admitted to our RR. Main causes for admission were active seizures (AS) (35%) and severe traumatic brain injuries (TBI) (18.8%). 44.1% were admitted to the PICU. Multivariate analysis through binary logistic regression determined that, concerning the likelihood of ICU admission, admittance with spinal board (p=0.012, odds ratio 5.7) and ventilatory support requirement (p=0.001, OR 17.1) were independent positive risk factors; being a frequent user of emergency services (p=0.016, OR 0.27) and admission for AS (p=0.007, OR 0.16) were negative risk factors. Trauma patients were the ones most likely to be admitted to the PICU (p<0.001) [among these, TBI was the most frequent cause for admission (p<0.001)]. Concerning length of PICU stay, the occurrence of cardiorespiratory arrest predicted a longer stay (p=0.023), while admittance due to an active seizure correlated to a relatively shorter stay (p=0.035).
Conclusions
In line with previous literature, we conclude that trauma (especially TBI) is a major cause of RR and PICU admission. Healthcare professionals working in this setting must be familiar with this condition. The importance of regular training sessions, including simulations, cannot be overlooked.