Epidemiology of pediatric critically-ill patients presenting to the pediatric emergency department

Abstract

This study aimed to analyze the epidemiologic patterns of pediatric critically-ill patients presenting to the emergency department (ED) and the etiologies of intensive care unit (ICU) admission of different age groups.This retrospective study of all children aged less than 18 years presenting with critical illnesses to the ED was conducted in a tertiary medical center in Taiwan from 2003 to 2007. All patients transferred to the ICU from the ED were included without distinction. Demographic data of critically-ill children admitted to the ED and ICU were analyzed. Etiologies of the ICU admissions were analyzed by various age groups.There were 2978 critically-ill children admitted to the ICU from the ED. In 120 pediatric patients with out-of-hospital cardiac arrest, cases with pulseless electrical activity or ventricular fibrillation had higher successful CPR rates than patients with asystole (both p<0.05). In patients admitted to ICUs, complications from the perinatal period, respiratory system diseases, accidental injuries and poisoning were the predominant etiologies respectively in young children (42.5%), school-aged children (38.5%), and adolescents (47.9%). Moreover, the most common of which was respiratory distress syndrome in neonates followed by bacterial pneumonia and status epilepticus.Epidemiologic analysis may provide primary clinicians to identify significant differences in admission rates based on different etiologies of various age groups.