Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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.

(Less)
Please use this url to cite or link to this publication:
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
2024-06-30 00:18:17
@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}},
}