[Care of critically-ill children in Asturias (Spain): characteristics and effectiveness]

OBJECTIVE: To describe the work performed in the Pediatric Intensive Care Unit of the Hospital Central de Asturias (Spain) in its first 5 years and to assess the effectiveness of the care provided. METHODS: A prospective study of the characteristics of critically-ill children admitted from 1996 to 2000 was performed. Effectiveness was defined as the ratio of observed to expected mortality, determined by pediatric risk of mortality (PRISM) score calculated 24 hours after admission. RESULTS: The median age of critically-ill children was 38 months and the mean length of stay was 6.8 days. Forty percent of the patients were transferred from other hospitals in Asturias and Leon. The most frequent causes of admission were respiratory, neurological and infectious diseases, and trauma. Overall mortality was 4.3 %. Over the years the severity of the patients increased with a consequent rise in mean length of stay, use of central venous access and mechanical ventilation. Forty-two percent of deaths were expected. The effectiveness of care was high among high-risk patients, among those with respiratory and metabolic diseases and in the postoperative period but was low among patients with hematologic and gastrointestinal diseases. Effectiveness increased over time. CONCLUSIONS: Studies analyzing pediatric intensive care units are useful for assessing and improving the effectiveness of care in these centers.