• David Epstein, Carolyn F Wong, Robinder G Khemani, David Y Moromisato, Karen Waters, Michele D Kipke, and Barry P Markovitz.
• Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, 4650 Sunset Blvd, MS #3, Los Angeles, CA 90027, USA. depstein@chla.usc.edu
• Pediatrics. 2011 Mar 1; 127 (3): e588-97.

ObjectiveTo determine if a difference in survival exists between children of different racial/ethnic groups who were admitted to the PICU, after controlling for severity of illness (pediatric index of mortality 2).MethodsWe used the largest national clinical PICU database (Virtual PICU Performance System) with data from 31 hospitals, from 2005 to 2008. Children 18 years and younger were included. We collected demographic, pediatric index of mortality 2, diagnosis, and PICU mortality data. Logistic regression models were constructed to identify PICU mortality risk factors.ResultsThe analysis of 80 739 patients revealed that, after controlling for severity of illness, being female (odds ratio [OR]: 1.12 [95% confidence interval (CI): 1.02-1.24] P = .019), 1 month or younger (OR: 1.39 [95% CI: 1.17-1.65] P < .001) or 12 years or older (OR: 1.34 [95% CI: 1.17-1.52] P < .001), or having an infectious diagnosis (OR: 2.22 [95% CI: 1.83-2.71] P < .001) or oncologic diagnosis (OR: 1.50 [95% CI: 1.14-1.99] P = .004) increased PICU mortality. Having "other" insurance type (OR: 1.58 [95% CI: 1.11-2.24] P = .010) or being Asian/Indian/Pacific Islander (OR: 1.35 [95% CI: 1.01-1.81] P = .042) seemed also to be mortality risk factors; however, because of heterogeneity and small group sizes (1.7% and 2.5% of the study population, respectively), these results are inconclusive.ConclusionsAlthough gender, age, and diagnosis showed an effect on severity of illness-adjusted PICU mortality, race/ethnicity did not. Additional investigation is warranted because the present results (ie, insurance type) may be proxy measurements for other influences not collected in this database, such as sociocultural and socioeconomic factors.

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