ID | 60365 |
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Author |
Tsukahara, Kohei
Department of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
publons
Naitou, Hiromichi
Department of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
publons
Yorifuji, Takashi
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
Kaken ID
publons
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Nosaka, Nobuyuki
Department of Pediatrics, Cedars-Sinai Medical Center
Yamamoto, Hirotsugu
Department of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Osako, Takaaki
Department of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nakao, Atsunori
Department of Emergency, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
the JaRPAC Study Group
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Abstract | The importance of centralizing treatment services for severely ill children has been well established, but such entralization remains difficult in Japan. We aimed to compare the trauma and illness severity and mortality of children admitted to two common types of ICUs for children. According to the type of management and disposition of the medical provider, we classified ICUs as pediatric ICUs [PICUs] or general ICUs, and analyzed differences in endogenous and exogenous illness settings between them. Overall, 1,333 pediatric patients were included, with 1,143 patients admitted to PICUs and 190 patients to general ICUs. The Pediatric Cerebral Performance Category score (PCPC) at discharge was significantly lower in the PICU group (adjusted OR: 0.45; 95%CI: 0.23-0.88). Death and unfavorable neurological outcomes occurred less often in the PICU group (adjusted OR: 0.29; 95%CI: 0.14-0.60). However, when limited to exogenous illness, PCPC scores (adjusted OR: 0.38; 95%CI: 0.07-1.99) or death/unfavorable outcomes (adjusted OR: 0.72; 95%CI: 0.08-6.34) did not differ between the groups. PCPC deterioration and overall sequelae/death rates were lower in PICUs for children with endogenous illnesses, although the outcomes of exogenous illness were similar between the 2 unit types. Further studies on the necessity of centralization are warranted.
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Keywords | kids
critical care
mortality
morbidity
centralization
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Amo Type | Original Article
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Publication Title |
Acta Medica Okayama
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Published Date | 2020-08
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Volume | volume74
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Issue | issue4
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Publisher | Okayama University Medical School
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Start Page | 285
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End Page | 291
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ISSN | 0386-300X
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NCID | AA00508441
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Content Type |
Journal Article
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language |
English
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Copyright Holders | CopyrightⒸ 2020 by Okayama University Medical School
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File Version | publisher
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Refereed |
True
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