Acute Neurologic Injury at the Pediatric Intensive Care Unit of Instituto Nacional de Salud del Niño, Lima - Perú. Results from a Multicentric Study
DOI:
https://doi.org/10.61651/rped.2014v67n4p195-203Keywords:
Nervous System Diseases, Intensive Care Units, Pediatric, Brain Injuries, TraumaticAbstract
Severe acute neurologic disease (AND) in children is associated with significant morbidity, mortality and high costs. Prevalence and outcomes are not known. The present study is part of an international, multicentric, prospective, observational, cross sectional study (PANGEA).
Objectives: To determine the prevalence and outcomes in children with acute neurologic disease in the Pediatric Intensive Care Unit (PICU) at the Instituto Nacional del Niño (INSN) in Lima – Peru. Methods: A cross sectional study was developed in 4 different days during a 12 month period (November 2011 – November 2012). Children from 7 days up to 17 years old with acute neurologic disease hospitalized in the PICU of INSN were admitted for the study. Acute Neurologic Disease included TBI, stroke, cardiac arrest, epileptic status, traumatic vertebral and medullar disease, CNS infection and children with chronic brain disease and concomitant acute neurologic disease; children with acute perinatal disease and children with chronic brain disease without concomitant acute neurologic disease were excluded. Results are presented as averages. A p value< 0.05 was considered significant.
Results: In the global study, 961 patients from 126 PICU of 23 countries were admitted. At the PICU of INSN 12 from 63 patients were included; prevalence in the 4 days were 25, 26.7, 12.5 y 12.5, respectively. Both, globally and at the PICU of INSN, cardiac arrest was the most common cause of neurologic disease; 50% of patients with acute neurologic disease in the INSN presented severe disability as outcome, in contrast with 35% in the global study. Our hospital stay was three times that of global study. Mortality was 25%.
Conclusions: Acute neurologic disease is an important cause of mortality and morbidity in children. Cardiac arrest was the most common cause of brain injury. Mortality, hospital stay and severe disabilities are frequent.
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