Last modified: 2018-09-09
Abstract
Objective: It was aimed to evaluate diagnosis, management and follow-up characteristics of acute neurological disorders treated in pediatric intensive care unit.
Material methods: The study included 156 patients (1 month-18 years) admitted to our hospital within a period of two years who had no known neurometabolic or neuromuscular diseases and were ordered neurology consultation.
Results: Mean age was 4.7±5.1 years in the study population; of the patients, 88 (56.4%) were male. When assessed according to age groups, 49.4% were aged 1-24 months whereas 35.9% were aged 25-144 months and 14.7% were aged >144 months. At admission, most common diagnoses were status epilepticus (38.5%) and central nervous system infection (9%). Hypoxic-ischemic causes were significantly more prevalent in patients aged <2 years whereas acute flaccid paralysis in patients aged>2 years (p<0.05). It was seen that mechanical ventilation was performed in 60.3% while plasma exchange in 10.9%, intravenous immunoglobulin therapy in 10.9% and pulse steroid therapy in 4.5%. The mortality was 9% in this study. Follow-up in outpatient settings was available in 93 (59.6%) of patients discharged; among these, mean follow-up was 8.6±4.3 months. There was abnormal neurological examination finding in 46.2%. It was found that presence of intensivist had significant effect of shortening of length of hospital stay and state of normal neurological examination at follow-up (p<0.05).
Conclusion: Glaskow coma score, need for mechanical ventilation and diagnosis at admission were factors influencing on mortality. Length of stay is shortened while morbidity is decreased in the presence of pediatric intensivist.