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Text
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Citation List Month
November 2017 List
Notes
<p>1557-8615<br />Hon, Kam Lun<br />Luk, Man Ping<br />Fung, Wing Ming<br />Li, Cho Ying<br />Yeung, Hiu Lee<br />Liu, Pui Kwun<br />Li, Shun<br />Tsang, Kathy Yin Ching<br />Li, Chi Kong<br />Chan, Paul Kay Sheung<br />Cheung, Kam Lau<br />Leung, Ting Fan<br />Koh, Pei Lin<br />Journal Article<br />United States<br />J Crit Care. 2017 Apr;38:57-61. doi: 10.1016/j.jcrc.2016.09.019. Epub 2016 Sep 30.</p>
Dublin Core
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Title
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Mortality, length of stay, bloodstream and respiratory viral infections in a pediatric intensive care unit
Publisher
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Journal of Critical Care
Date
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2017
Subject
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Length Of Stay; Asthma; Bacterial Coinfection; Child; Child Health Services; Child Preschool; Critical Care; Female; Hong Kong/epidemiology; Hospitalization; Humans; Infant; Intensive Care Units Pediatric; Leukemia; Logistic Models; Lymphoma; Male; Odds Ratio; Pediatric Intensive Care; Respiratory Tract Infections/complications/ Epidemiology/microbiology/mortality; Respiratory Virus; Retrospective Studies; Risk Factors; Sepsis/complications/ Epidemiology/microbiology/mortality; Survival Analysis
Creator
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Hon KL; Luk MP; Fung WM; Li CY; Yeung HL; Liu PK; Li S; Tsang KY; Li CK; Chan PK; Cheung KL; Leung TF; Koh PL
Description
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OBJECTIVES: We investigated whether diagnostic categories and presence of infections were associated with increased mortality or length of stay (LOS) in patients admitted to a pediatric intensive care unit (PICU). METHODS: A retrospective study of all PICU admissions between October 2002 and April 2016 was performed. Oncologic vs nononcologic, trauma/injuries vs nontraumatic, infectious (gram-positive, gram-negative, fungal bloodstream infections, common respiratory viruses) vs noninfectious diagnoses were evaluated for survival and LOS. RESULTS: Pediatric intensive care unit admissions (n = 2211) were associated with a mortality of 5.3%. Backward binary logistic regression showed that nonsurvival was associated with leukemia (odds ratio [OR], 4.81; 95% confidence interval [CI], 2.2-10.10; P < .0005), lymphoma (OR, 21.34; 95% CI, 3.89-117.16; P < .0005), carditis/myocarditis (OR, 7.91; 95% CI, 1.98-31.54; P = .003), encephalitis (OR, 6.93; 95% CI, 3.27-14.67; P < .0005), bloodstream infections with gram-positive organisms (OR, 5.32; 95% CI, 2.67-10.60; P < .0005), gram-negative organisms (OR, 8.23; 95% CI, 4.10-16.53; P < .0005), fungi (OR, 3.93; 95% CI, 1.07-14.42; P = .039), and pneumococcal disease (OR, 3.26; 95% CI, 1.21-8.75; P = .019). Stepwise linear regression revealed that LOS of survivors was associated with bloodstream gram-positive infection (B = 98.2; 95% CI, 75.7-120.7; P < .0005). CONCLUSIONS: Patients with diagnoses of leukemia, lymphoma, cardiomyopathy/myocarditits, encephalitis, and comorbidity of bloodstream infections and pneumococcal disease were significantly at risk of PICU mortality. Length of stay of survivors was associated with bloodstream gram-positive infection. The highest odds for death were among patients with leukemia/lymphoma and bloodstream coinfection. As early diagnosis of these childhood malignancies is desirable but not always possible, adequate and early antimicrobial coverage for gram-positive and gram-negative bacteria might be the only feasible option to reduce PICU mortality in these patients. In Hong Kong, a subtropical Asian city, none of the common respiratory viruses were associated with increased mortality or LOS in PICU.
Identifier
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10.1016/j.jcrc.2016.09.019
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Asthma
Bacterial Coinfection
Chan PK
Cheung KL
Child
Child Health Services
Child Preschool
Critical Care
Female
Fung WM
Hon KL
Hong Kong/epidemiology
Hospitalization
Humans
Infant
Intensive Care Units Pediatric
Journal of Critical Care
Koh PL
Length Of Stay
Leukemia
Leung TF
Li CK
Li CY
Li S
Liu PK
Logistic Models
Luk MP
Lymphoma
Male
November 2017 List
Odds Ratio
Pediatric Intensive Care
Respiratory Tract Infections/complications/ Epidemiology/microbiology/mortality
Respiratory Virus
Retrospective Studies
Risk Factors
Sepsis/complications/ Epidemiology/microbiology/mortality
Survival Analysis
Tsang KY
Yeung HL