Epidemiological survey of critically ill pediatric patients requiring intensive care

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K11437
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Emergency medicine
• Research Institution: Osama Woman's and Children's Hospital
• Principal Investigator: Hatachi Takeshi 地方独立行政法人大阪府立病院機構大阪母子医療センター(研究所), その他部局等, 集中治療科・副部長 (00528797)
• Co-Investigator(Kenkyū-buntansha): 竹内 宗之 地方独立行政法人大阪府立病院機構大阪母子医療センター(研究所), その他部局等, 集中治療科・主任部長 (00774647)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 集中治療 / 小児救急 / 重症

Outline of Final Research Achievements

We prospectively conducted an observational study of critically ill pediatric emergency patients aged ＜15 years in three medical regions in the southern part of Osaka Prefecture for 1 year, beginning in April 2015. We identified 196 patients with a median age of 2 years. Approximately 41% of the patients had underlying diseases. Of these, 87% demonstrated endogenous diseases, 44% had infections, and 10% suffered injuries secondary to suspected child abuse. The 1-year incidence of critically ill pediatric emergency patients was 0.641 per 1,000 children, the mortality rate was 10%, and 19% died or had decreased neurological function on evaluation. Cardiopulmonary resuscitation, impaired consciousness after 24 h, acute virus-associated encephalopathy, and mechanical ventilation were associated with poor outcomes.

Free Research Field

集中治療

Academic Significance and Societal Importance of the Research Achievements

日本には欧米豪と比較して小児集中治療室が少ないため小児集中治療室を整備することにより患者の予後を改善できる可能性があるが、整備のためのデータが充分でなかった。小児集中治療を必要とする重症小児救急患者について網羅的な疫学調査を行い、日本における小児集中治療室の整備に必要な基礎的なデータを得ることができた。また予後不良な患者の危険因子を明らかにすることができ、今後の重症小児救急患者の治療に資することが可能となった。