Mortality-associated factors in the pediatric intensive care setting: a retrospective review of 519 patients in Çanakkale, Türkiye

Introduction: The Pediatric Intensive Care Unit plays a vital role in the management and continuous monitoring of life-threatening conditions affecting multiple organ systems. In recent years, the demand for pediatric intensive care services in our country has increased significantly. However, patient survival is influenced not only by bed availability but also by the quality of care provided. Therefore, identifying and analyzing mortality predictors is of critical importance for improving the quality of care in Pediatric Intensive Care Units (PICUs). This study aims to evaluate the clinical characteristics of patients admitted to the Pediatric Intensive Care Unit of Çanakkale Onsekiz Mart University Hospital and to identify the variables associated with survival outcomes. Methods: In this retrospective cross-sectional study, the medical records of 519 patients admitted to the PICU of Çanakkale Onsekiz Mart University Hospital between May 1, 2019, and December 31, 2022, were reviewed. Collected data included demographic characteristics, admission diagnoses, length of stay in the ICU, need for invasive procedures, complications developed during hospitalization, and clinical scoring systems such as the Glasgow Coma Scale (GCS), Pediatric Risk of Mortality III (PRISM III), Pediatric Index of Mortality 2 (PIM2), and Pediatric Logistic Organ Dysfunction-2 (PELOD-2). Statistical analyses were conducted using appropriate tests, and factors associated with mortality were evaluated through logistic regression analysis. Results: Among the 519 patients included in the study, 55.3% were male, and the median age was 55 months. The most frequent reasons for hospitalization were infectious diseases (31.2%), neurological disorders (15.1%), and intoxications (10.6%). Additionally, 27.0% of the patients had at least one chronic condition. Notably, the rate of intoxication was particularly high in the 97–216-month age group (69.4%). There was a statistically significant association between mortality and all the evaluated scoring systems, namely PRISM III, PIM2, PELOD-2, and the GCS (p = 0.001). Logistic regression analysis identified previous intensive care unit admission [OR: 4.697–6.898], the need for mechanical ventilation [OR: 0.151–0.094], and the development of nosocomial infection [OR: 2.474] as independent predictors of mortality (p = 0.021). Conclusion: Survival outcomes in pediatric intensive care are influenced not only by diagnostic and therapeutic interventions but also by factors such as hospital-acquired infections, the need for mechanical ventilation, and prior intensive care unit admissions. Clinical scoring systems such as PRISM III, PIM2, and PELOD-2 offer valuable prognostic insight and contribute to clinical decision-making. The findings of this study provide important data for the assessment and enhancement of current pediatric intensive care practices. Therefore, the regular analysis of factors influencing mortality represents a critical step toward improving the quality of care delivered in PICUs.