Five-Year Survival and Causes of Death in Children After Intensive Care—A National Registry Study

Objectives: The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age. Design: Longitudinal follow-up study. Setting: Registry study of a national ICU register and hospital registries. Patients: Children admitted to an ICU in the years 2009 and 2010. Interventions: None. Measurements and Main Results: The mortality and causes of death following ICU discharge were analyzed retrospectively. The median follow-up period was 4.9 years (25–75th percentiles, 4.4–5.5 yr). The causes of death in survivors 30 days after ICU discharge were compared with a cohort of 1 million children of the general population of same age. In total, 2,792 children were admitted to an ICU during the study period. Of those, 53 (1.9%) died in the ICU and 2,739 were discharged. Thirteen children died within 30 days of discharge, and 68 died between 30 days and the end of follow-up (December 31, 2014). In the control population (n = 1,020,407 children), there were 1,037 deaths (0.10%) from 2009 to 2014. The standardized mortality rate for the children admitted to the ICU during the study period was 53.4 (95% CI, 44.7–63.2). The standardized mortality rate for those children alive 1 year after discharge was 16.7 (12.1–22.6). One-year cumulative mortality was 3.3%. The most common causes of death in subjects alive 30 days post ICU were cancer (35.3%), neurologic (17.6%), and metabolic diseases (11.7%), whereas trauma was the most common cause in the control group (45.3%). Conclusions: There was an increased risk of death in a cohort of ICU-admitted children even 3 years after discharge. In those who survived 30 days after discharge, medical causes of death were dominant, whereas deaths due to trauma were most common in the control group. Supported, in part, by grants from the Finnish Foundation for Pediatric Research and Alma and K.A. Snellman Foundation. Dr. Kyösti received funding from a Finnish grant for Pediatric Research and Alma and K.A. Snellman foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: elina.kyosti@ppshp.fi ©2017The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

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