Systematic Review and Meta-Analysis on the Pattern of Admissions and Treatment Outcomes in PICU
DOI:
https://doi.org/10.52783/jns.v14.2535Keywords:
Pediatric Intensive Care Unit (PICU), respiratory illness, sepsis, neurological disorders, mechanical ventilation, child mortality, comorbidities, low- and middle-income countries, critical care outcomes, systematic reviewAbstract
Background: Pediatric Intensive Care Units (PICUs) provide critical care to children with life-threatening illnesses. However, admission patterns and treatment outcomes vary significantly, especially in resource-limited settings.
Objectives: This systematic review and meta-analysis aimed to evaluate the patterns of admissions and treatment outcomes in PICUs, with a focus on developing countries including India, to inform strategies that can enhance pediatric critical care delivery.
Methods: Following PRISMA guidelines, a comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar. Studies focusing on PICU admissions, treatment outcomes, and mortality-related factors in resource-limited settings were included. A total of 20 studies met the inclusion criteria and were analyzed qualitatively and quantitatively.
Results: The analysis included 9,243 pediatric patients. Respiratory illnesses (19.1%–49%) were the leading cause of admissions, followed by neurological disorders (14.3%–33.2%) and sepsis (3.4%–40%). Mechanical ventilation was required in up to 100% of cases in some studies. Mortality rates ranged from 4.1% to 74%, averaging 19.8%. Key mortality predictors included sepsis, multi-organ dysfunction syndrome (MODS), prolonged mechanical ventilation, and low Glasgow Coma Scale (GCS) scores. Male patients showed higher mortality across most studies. Comorbidities such as malnutrition, acute kidney injury, and congenital heart defects were also associated with poor outcomes.
Conclusions: PICUs play a vital role in reducing pediatric mortality, but outcomes are influenced by the availability of resources, early interventions, and management of comorbidities. Strengthening infrastructure, early sepsis recognition, and critical care training are essential to improve outcomes in low- and middle-income countries.
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