Prevalence of anemia on admission to Pediatric Intensive Care unit and its relation to outcome

Abstract

Anemia is frequently encountered in critically ill children and has been associated with adverse clinical outcomes. Although anemia is highly prevalent in many low- and middle-income countries, data describing its burden among children admitted to pediatric intensive care units (PICUs) in North Africa remain scarce.
Objective To determine the prevalence of anemia in critically ill patients at the time of admission to pediatric intensive care unit and to find out its relation to mortality as an outcome. 
Design: All children admitted to Pediatric Intensive care unit (PICU) were studied for their Haemoglobin Level before or at the time of admission to PICU. Presence of Anemia Defined according to normal haemoglobin values provided. Mortality rate in anemic and non-anemic children were calculated. 
Subjects: all children admitted to PICU of Tripoli children hospital from Jan one 2014 to Dec 31th 2014 were included. All patients were above one month of age.
Results: A total of 310 children were admitted during the study period, including 170 (54.8%) males and 140 (45.2%) females. Infants younger than one year represented the largest age group (51.2%). Anemia on admission was identified in 159 children (51.3%). Overall PICU mortality was 17.4% (54/310). Among children who died, 39 (72.2%) were anemic at admission, whereas 15 (27.8%) were not anemic. The crude mortality rate among anemic children was higher than among non-anemic children (24.5% vs. 9.9%), suggesting an association between admission anemia and increased risk of death.
Conclusion and recommendations: The prevalence of anemia among children admitted to intensive care unit whatever the reason for admission and their primary illness is high. Deaths among those with anemia on admission was very high (72%). As anemia is common illness in the community we recommend some measures to be taken to prevent and treat this problem which may decrease both rate of admission and mortality in ICU. Measures have to be considered in sitting of intensive care management for those with anemia on admission too.