Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Objective:
The aim of the study was to determine the outcome of critically ill neonates and children
admitted to a general intensive care unit in a large regional hospital (Worcester) in the
Western Cape. A secondary aim of the study was to determine the risk factors for death in
these neonates and children.
Methodology:
This was a retrospective descriptive survey of all paediatric admissions (under 13 years of
age; July 2008 till June 2009) to an intensive care unit at a large regional hospital in
Worcester, South Africa. Data collected included: demography, admission time, length of
stay, diagnoses, interventions and outcome. Outcome was defined as successful discharge,
death or transfer to a central hospital.
Results:
There were 194 admissions including children and neonates. The files of 185 children and
neonates were analysed, while 8 children were excluded due to incomplete data set and one
patient was a surgical admission. The male: female ratio was 1.3: 1 and the majority of
patients (83%) admitted, were younger than 12 months of age at admission with a mean age
of 8.5 months (median age 3.7 months; range 0 to 151 months). The majority (70%) of
admissions were successfully discharged, nearly a quarter (24%) transferred to central
hospitals in Cape Town and only 6% died (all younger than 5 years of age). Causes of death
included acute lower respiratory tract infections (33%), acute gastroenteritis (25%), birth
asphyxia complicated by pulmonary hypertension (16%) and prematurity (16%). Patients
requiring airway assistance, were more likely to experience an adverse event (p=0.0001) and
invasive ventilation was associated with an increased risk for a poor outcome (p=0.00). Conclusion:
The majority of children requiring access to a paediatric ICU are younger than one year of
age. The common causes of death are acute lower respiratory tract infections, acute
gastroenteritis, prematurity and neonatal asphyxia. A regional hospital in South Africa should
offer intensive care to children as the majority of their admissions can be successfully cared
for without transfer to tertiary hospitals. To our knowledge, this is the first study reporting
admissions and outcome of neonates and children cared for in a mixed intensive care unit in a
large regional hospital in South Africa. This study suggests that large regional hospitals in
South Africa should have mixed intensive care units to improve child survival.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/86757 |
| Date | 04 1900 |
| Creators | Kruger, Irma |
| Contributors | Kruger, M., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Rights | Stellenbosch University |
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