Leading Cause of Death in Pediatric Intensive Care Unit (PICU): A Single-Center Study from Southern Iran

Abstract

Background: Pediatric in-hospital mortality is a key indicator of healthcare quality, particularly in pediatric intensive care units (PICUs), where critically ill children receive specialized care. Understanding the documented leading cause of death is crucial for improving patient outcomes and guiding healthcare interventions. This study examined the medical diagnoses recorded at the time of death among pediatric patients in the PICU of Bandar Abbas Children's Hospital. Objectives: This study aimed to analyze the documented leading cause of death and the demographic characteristics of deceased patients in the PICU of Bandar Abbas Children's Hospital over one year. Additionally, it evaluated the impact of seasonal variations and PICU length of stay on mortality patterns. Methods: A retrospective analysis was conducted from April 2023 to March 2024, reviewing medical records of all patients aged 28 days to under 18 years who died in the PICU. Collected data included age, gender, underlying conditions, final medical diagnoses, and PICU stay duration. Statistical analyses, including chi-square and t-tests, were performed using SPSS version 21. Results: The mortality rate was 60.4%, with 125 deaths among 207 admitted patients. Of the deceased patients, 52% were female and 48% male, with the highest mortality observed in children under one year old (38.4%). The most frequently documented leading causes of death included infectious diseases (41.3%), neurological conditions, and cases classified as unknown etiology due to incomplete diagnostic data. Most deaths (55.2%) occurred within the first week of PICU admission. Although winter had the highest mortality rate (36.8%), seasonal differences were not statistically significant. Gender differences in mortality patterns were also non-significant (P > 0.05). Conclusions: The most commonly recorded leading causes of death in the PICU were infections, followed by neurological conditions and cases of unknown etiology. The study highlights the need for improved diagnostic accuracy, better documentation practices, and timely interventions, particularly for younger children and those at higher risk of early mortality. Future research should incorporate detailed cause-of-death classifications to enhance understanding and improve PICU outcomes.