Pediatric anesthesia & critical care
Recurrent Intensive Care Episodes and Mortality Among Children With Severe Neurologic Impairment
Authors' conclusion
This cohort study of children with SNI demonstrated a modest dose-dependent association between PICU-CIEs and short-term mortality.
Study context
- Population
- Children born 2002–2019 with an severe neurologic impairment (SNI) diagnosis code in an Ontario, Canada, hospital record before 16 years of age, discharged alive after a first PICU-CIE
- Participants
- 4,774 children
- Exposure
- Number and severity of PICU critical illness episodes (PICU-CIEs) in the preceding year
- Outcome
- One-year survival conditioned on the number and severity (LOS >15 days or invasive mechanical ventilation) of PICU-CIEs in the preceding year
- Follow-up
- 1 year
Methodological detailshealth administrative data, Data analyzed November 2021 to June 2023
- Health administrative data
- Data analyzed November 2021 to June 2023
Main finding
As reported in the abstract
Conditional 1-year mortality less than 20% regardless of number or severity of recent PICU-CIEs
<20%
High-risk PICU-CIEs: 1-year conditional survival after the first PICU-CIE
90%
95% CI 89%–91%
High-risk PICU-CIEs: 1-year conditional survival after the fourth PICU-CIE
81%
95% CI 77%–86%
Observational data: associations, not effects.
Further findings
Mortality by nonneurologic complex chronic conditions and medical technology assistance
| aHR (95% CI) | ||
|---|---|---|
| Nonneurologic complex chronic conditionsAdjusted for age category and demographic factors | 1.70 (1.43–2.02) | |
| Medical technology assistanceAdjusted for age category and demographic factors | 2.32 (1.92–2.81) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Ten-year survival after the initial episode, by age · 10 years
- Children <1 year
- 81% (95% CI, 79%-82%)
- Children ≥1 year
- 84% (95% CI, 82%-86%)
Survival 15 years after the initial episode (age-stratified curves converged)
- Children <1 year
- 79% (95% CI, 78%-81%)
- Children ≥1 year
- 79% (95% CI, 75%-84%)
Original publication
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