Evaluation of pediatric intensive care in Europe. A collaborative study by the European Club of Pediatric Intensive Care

Abstract

There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p less than 0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p less than 0.01 v.s. respiratory, p less than 0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p less than 0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes.(ABSTRACT TRUNCATED AT 250 WORDS)