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

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Ehinger, J. K., Karlsson, M., Sjövall, F., Leffler, M., McCormack, S. E., Kubis, S. E., Åkesson, A., Falk, M. J., & Kilbaugh, T. J. (2021). Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit. Pediatric Research, 90(6), 1221-1227. https://doi.org/10.1038/s41390-021-01410-z

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Author

Ehinger, Johannes K ; Karlsson, Michael ; Sjövall, Fredrik ; Leffler, Märta ; McCormack, Shana E ; Kubis, Sherri E ; Åkesson, Anna ; Falk, Marni J ; Kilbaugh, Todd J. / Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit. I: Pediatric Research. 2021 ; Bind 90, Nr. 6. s. 1221-1227.

Bibtex

@article{9a7fc241984548e6bf54f446b10af3bb,
title = "Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit",
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; 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 stay PRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.",
author = "Ehinger, {Johannes K} and Michael Karlsson and Fredrik Sj{\"o}vall and M{\"a}rta Leffler and McCormack, {Shana E} and Kubis, {Sherri E} and Anna {\AA}kesson and Falk, {Marni J} and Kilbaugh, {Todd J}",
note = "{\textcopyright} 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.",
year = "2021",
month = dec,
doi = "10.1038/s41390-021-01410-z",
language = "English",
volume = "90",
pages = "1221--1227",
journal = "Pediatric Research",
issn = "0031-3998",
publisher = "Nature Publishing Group",
number = "6",

}

RIS

TY - JOUR

T1 - Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit

AU - Ehinger, Johannes K

AU - Karlsson, Michael

AU - Sjövall, Fredrik

AU - Leffler, Märta

AU - McCormack, Shana E

AU - Kubis, Sherri E

AU - Åkesson, Anna

AU - Falk, Marni J

AU - Kilbaugh, Todd J

N1 - © 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

PY - 2021/12

Y1 - 2021/12

N2 - 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 stay PRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.

AB - 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 stay PRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.

UR - http://www.scopus.com/inward/record.url?scp=85101764867&partnerID=8YFLogxK

U2 - 10.1038/s41390-021-01410-z

DO - 10.1038/s41390-021-01410-z

M3 - Journal article

C2 - 33627817

VL - 90

SP - 1221

EP - 1227

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

IS - 6

ER -

ID: 72899036