• Ryan L DeSanti, Binod Balakrishnan, Tom B Rice, Jose A Pineda, and Peter A Ferrazzano.
• Department of Pediatrics, Drexel University College of Medicine, St Christopher's Hospital for Children, Philadelphia, PA.
• Pediatr Crit Care Me. 2022 Sep 1; 23 (9): 676686676-686.

ObjectivesTo define the prevalence of neurologic diagnoses and evaluate the utilization of critical care and neurocritical care (NCC) resources among children admitted to the PICU.DesignRetrospective cohort analysis.SettingData submitted to the Virtual Pediatric Systems (VPS) database.PatientsAll children entered in VPS during 2016 (January 1, 2016, to December 31, 2016).InterventionsNone.Measurements And Main ResultsThere were 128,688 patients entered into VPS and were comprised of 24.3% NCC admissions and 75.7% general PICU admissions. The NCC cohort was older, represented more scheduled admissions, and was more frequently admitted from the operating room. The NCC cohort also experienced a greater decline in prehospitalization to posthospitalization functional status and required more frequent use of endotracheal intubation, arterial lines, and foley catheters but had an overall shorter duration of PICU and hospital length of stay with a higher mortality rate. One thousand seven hundred fifteen patients at 12 participating institutions were entered into a novel, pilot NCC module evaluating sources of secondary neurologic injury. Four hundred forty-eight patients were manually excluded by the data entrant, leaving 1,267 patients in the module. Of the patients in the module, 75.8% of patients had a NCC diagnosis as their primary diagnosis; they experienced a high prevalence of pathophysiologic events associated with secondary neurologic insult (ranging from hyperglycemia at 10.5% to hyperthermia at 36.8%).ConclusionsIn children admitted to a VPS-contributing PICU, a diagnosis of acute neurologic disease was associated with greater use of resources. We have identified the most common etiologies of acute neurologic disease in the 2016 VPS cohort, and such admissions were associated with significant decrease in functional status, as well as an increase in mortality.Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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