Admission Patterns and Outcome in a Pediatric Intensive Care Unit in Nepal

Aims: To study the admission patterns and outcome of children in a Pediatric Intensive Care Unit (PICU) in Nepal.
Methods: Demographic profile, diagnosis, treatment, supportive measures and outcome of children admitted to the PICU of B P Koirala Institute of Health Sciences from April 2011 to March 2012 were reviewed.
Results: 230 children were admitted to the PICU with male to female ratio of 1.7:1. Diagnoses included respiratory diseases (n=76, 33%), central nervous system diseases (n=43, 18.6%), infectious diseases (n=26, 11.3%), surgical problems (n=18, 7.8%), gastrointestinal diseases (n=17, 7.4%), cardiovascular diseases (n=15, 6.5%), poisonings (n=11, 4.8%), renal (n=9, 3.9%), hematological (n=3, 1.3%) and others (n=12, 5.4%). Out of 230 admitted children, 29 (12.6%) died, 19 (8.2%) left against medical advice and 5 (2%) were referred to other centers. Forty-one (17.8%) children received mechanical ventilation, among which 23 (56%) improved, 14 (34.1%) died and 4 (9.7%) children were taken away by caretakers against medical advice.
Conclusion: Respiratory, central nervous system and infectious disease were the common reasons for admission. Children with infectious diseases and need for mechanical ventilation had higher mortality. Therefore, these patients require early referral and timely institution of therapy for better outcome; and intensive care facilities should be expanded to decrease child mortality.