The New England journal of medicine
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Letter Case Reports
Inadvertent chlorpropamide hypoglycemia--no longer once in a blue moon?
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We surveyed nine pediatric intensive care units (ICUs) to compare patient populations and to test prospectively the hypothesis that differences in mortality rates were due to differences in severity of illness. Age, clinical service, the reason for admission (emergency or scheduled), and the seriousness of the underlying chronic disease were recorded on admission. The severity of illness was assessed on the day of admission with a physiology-based measure, the Physiologic Stability Index. ⋯ Mortality rates also differed significantly (range, 3.0 to 17.6 percent; P less than 0.0001), as did the Physiologic Stability Index scores (P less than 0.0001). The mathematical function based on the Physiologic Stability Index score and on age reliably predicted the outcomes in all ICUs. We conclude that differences in mortality rates among pediatric ICUs can be explained by differences in the severity of illness.