Quality of Paediatric Intensive Care in the Czech Republic

Overview

Objective:
The objective of the work was to assess the severity of the condition in children hospitalized at unitsof intensive and resuscitation care in hospitals of the Czech Republic, to assess the actual and predicted mortalityand their ratio - the standardized mortality ratio - SMR.Type of study: Prospective observational multicentre study during Jan. 1. 2001 to Jan. 1, 2002.Place: 11 units of intensive and resuscitation paediatric care in hospitals Czech Republic. Patients: All children hospitalized in 2001 at intensive and resuscitation care units of collaborating departments.Method: In all children the PRISM score on admission was assessed, the predicted mortality was defined andthe actual mortality was assessed as well as their ratio (SMR - standardised mortality ratio). The predictedmortality, actual mortality andSMR was assessed for different categories of patients by PRISM score on admission(0 - 4, 5 - 9, 10 - 14, 15 - 19, 20 - 24, 25 - 29, > 30).Results: A total of 2934 children were included in the study with a mean hospitalization period of 5.4 days andmean PRISM score of 5.6. The predicted mortality derived from the PRISM score was 4.6% (the death of135 patientswas predicted).The actualmortalitywas 3.1%- 92 patients died. TheSMR is 0.68. Also in all categoriesaccording to the level of the PRISM score the actual mortality was lower than the predicted one (SMR < 1).Conclusion: The mean PRISM score of children hospitalized at intensive care units during the period ofinvestigation was 5.6 which predicts a mortality of 4.6%. The actual mortality was 3.1% and the SMR 0.68. Thesedata provide evidence of a very good standard of care provided by paediatric intensive care departments.

Key words:
PRISM score, intensive care, Standardised Mortality Ratio, children, quality