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Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit

Ehinger, Johannes K. LU orcid ; Karlsson, Michael LU ; Sjövall, Fredrik LU orcid ; Leffler, Märta LU orcid ; McCormack, Shana E. ; Kubis, Sherri E. ; Åkesson, Anna ; Falk, Marni J. and Kilbaugh, Todd J. (2021) In Pediatric Research 90(6). p.1221-1227
Abstract

Background: The aim of this study was to identify factors predicting outcome in patients with mitochondrial disease admitted to pediatric intensive care units (PICU). Methods: Retrospective study of 2434 patients (age <21 years) admitted to a PICU from 1 January 2006 through 31 March 2016 and captured in the Virtual Pediatric Systems database with ICD9 diagnosis 277.87, disorders of mitochondrial metabolism. Factors influencing mortality and prolonged length of stay (≥14 days) were analyzed using logistic regression. Results: Predictors independently affecting mortality (adjusted odds ratios and 95% confidence intervals, p < 0.05): age 1–23 months 3.4 (1.7–6.6) and mechanical ventilation 4.7 (2.6–8.6) were risk factors;... (More)

Background: The aim of this study was to identify factors predicting outcome in patients with mitochondrial disease admitted to pediatric intensive care units (PICU). Methods: Retrospective study of 2434 patients (age <21 years) admitted to a PICU from 1 January 2006 through 31 March 2016 and captured in the Virtual Pediatric Systems database with ICD9 diagnosis 277.87, disorders of mitochondrial metabolism. Factors influencing mortality and prolonged length of stay (≥14 days) were analyzed using logistic regression. Results: Predictors independently affecting mortality (adjusted odds ratios and 95% confidence intervals, p < 0.05): age 1–23 months 3.4 (1.7–6.6) and mechanical ventilation 4.7 (2.6–8.6) were risk factors; post-operative 0.2 (0.1–0.6), readmission 0.5 (0.3–0.9), and neurologic reason for admittance 0.3 (0.1–0.9) were factors reducing risk. Predictors affecting prolonged length of stay: mechanical ventilation 7.4 (5.2–10.3) and infectious reason for admittance 2.0 (1.3–3.2) were risk factors, post-operative patients 0.3 (0.2–0.5) had lower risk. The utility of PRISM and PIM2 scores in this patient group was evaluated. Conclusions: The single most predictive factor for both mortality and prolonged length of stay is the presence of mechanical ventilation. Age 1–23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stay. Impact: Presence of mechanical ventilation is the factor most strongly associated with negative outcome in patients with mitochondrial disease in pediatric intensive care.Age 1–23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stayPRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pediatric Research
volume
90
issue
6
pages
1221 - 1227
publisher
International Pediatric Foundation Inc.
external identifiers
  • pmid:33627817
  • scopus:85101764867
ISSN
0031-3998
DOI
10.1038/s41390-021-01410-z
language
English
LU publication?
yes
id
ef7cb105-8a94-484c-b610-45a5700a6704
date added to LUP
2021-12-23 14:32:45
date last changed
2025-01-13 20:33:26
@article{ef7cb105-8a94-484c-b610-45a5700a6704,
  abstract     = {{<p>Background: The aim of this study was to identify factors predicting outcome in patients with mitochondrial disease admitted to pediatric intensive care units (PICU). Methods: Retrospective study of 2434 patients (age &lt;21 years) admitted to a PICU from 1 January 2006 through 31 March 2016 and captured in the Virtual Pediatric Systems database with ICD9 diagnosis 277.87, disorders of mitochondrial metabolism. Factors influencing mortality and prolonged length of stay (≥14 days) were analyzed using logistic regression. Results: Predictors independently affecting mortality (adjusted odds ratios and 95% confidence intervals, p &lt; 0.05): age 1–23 months 3.4 (1.7–6.6) and mechanical ventilation 4.7 (2.6–8.6) were risk factors; post-operative 0.2 (0.1–0.6), readmission 0.5 (0.3–0.9), and neurologic reason for admittance 0.3 (0.1–0.9) were factors reducing risk. Predictors affecting prolonged length of stay: mechanical ventilation 7.4 (5.2–10.3) and infectious reason for admittance 2.0 (1.3–3.2) were risk factors, post-operative patients 0.3 (0.2–0.5) had lower risk. The utility of PRISM and PIM2 scores in this patient group was evaluated. Conclusions: The single most predictive factor for both mortality and prolonged length of stay is the presence of mechanical ventilation. Age 1–23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stay. Impact: Presence of mechanical ventilation is the factor most strongly associated with negative outcome in patients with mitochondrial disease in pediatric intensive care.Age 1–23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stayPRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.</p>}},
  author       = {{Ehinger, Johannes K. and Karlsson, Michael and Sjövall, Fredrik and Leffler, Märta and McCormack, Shana E. and Kubis, Sherri E. and Åkesson, Anna and Falk, Marni J. and Kilbaugh, Todd J.}},
  issn         = {{0031-3998}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1221--1227}},
  publisher    = {{International Pediatric Foundation Inc.}},
  series       = {{Pediatric Research}},
  title        = {{Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit}},
  url          = {{http://dx.doi.org/10.1038/s41390-021-01410-z}},
  doi          = {{10.1038/s41390-021-01410-z}},
  volume       = {{90}},
  year         = {{2021}},
}