• Ayman Al-Eyadhy, Mohamad-Hani Temsah, Gamal M Hasan, Mohammed Almazyad, Ali A Alhaboob, Majed Alabdulhafid, Fahad Alsohime, Ahmed S Alzahrani, Abdullah M Alammari, Faisal S Abunohaiah, Nawaf F Alfawzan, and Suhail S Alghamdi.
• From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
• Saudi Med J. 2021 Nov 1; 42 (11): 1186-1194.

ObjectivesTo identify the causes, modes, and timing of death in a tertiary pediatric intensive care unit (PICU).MethodsThis is a retrospective data analysis of patients older than 48 hours and younger than 15 years who died in the PICU over a 5-year period from January 2012 until December 2016 at a tertiary hospital in Riyadh, Saudi Arabia.ResultsThere were 101 deaths out of 2295 admissions, representing average crude mortality rate of 4.4%. Sepsis was the most common cause of death in 31 patients (30.7%), followed by lower respiratory tract infections in 19 (18.8%), and cardiac diseases in 12 (11.9%). Failed cardiopulmonary resuscitation was the most common mode of death in 51 patients (50.5%), followed by withholding life-sustaining treatment in 43 (42.6%), and brain death in 7 (6.9%). Although more deaths occurred during after hours (n=70; 69.3%), there was no significant correlation between mode of death and working hours vs. after hours (p>0.05). Among the cohort, 63 patients (62.4%) had an infection-attributed mortality, of which 43 (68.3%) were bacterial, 14 (22.2%) were viral, and 10 (15.9%) were fungal.ConclusionInfections remain a significant cause of death in the PICU. Further improvement of prevention programs and early therapy of severe infections could lower pediatric mortality. This report highlights the need for enhancing palliative care programs. The low rate of brain death diagnoses warrants further investigation.Copyright: © Saudi Medical Journal.

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