IMPROVING OUTCOME IN PEDIATRIC INTENSIVE CARE UNIT IN ACADEMIC HOSPITAL IN PAKISTAN

Objective: To assess the impact on the clinical outcome of critically ill children before and after introduction of pediatric intensivist in an academic pediatric intensive care unit (PICU) in Pakistan. Methodology: This is a retrospective audit of children (age from one month to 14 years) admitted in the PICU during two 12-month periods in PICU of Aga Khan University Hospital (AKUH). Patients in Cohort one were managed by pediatric intensivist while in Cohort two were managed by general pediatricians. Patients were compared during the two 12-month cohort period. Results: During the study, in cohort one, 314 patients were admitted, mean age was 24 months (range, one month - 14 year), 37% were less than 1-year old, 66% were male, mean PRISM Score was 13.2(3-39) while in cohort 2, 99 patients were admitted; mean age was 29 months and 60% were male. There were similar medical diagnostic categories in both cohorts. There were significant differences in two cohort for mortality (35% vs. 14%), length of stay (7.5 days vs. 3.2 days) (p<0.01) and number of admissions (314 vs. 99). Conclusion: Our data showed that implementation of full-time trained pediatric intensivist in a tertiary-care PICU of university hospital was associated with improve outcome of critically ill children.