Children’s death rates fall sharply in ICUs

A child given intensive care for a serious respiratory illness or other life-threatening disease has a significantly better chance of surviving now than he or she would have had as recently as the 1980s, according to a new federally sponsored study.

The death rate of children admitted to hospital pediatric intensive care units for diseases such as asthma, bronchitis, and pneumonia declined by 45% between the early to mid-1980s and 1993, the government researchers found.

The study was jointly sponsored by the Agency for Health Care Policy and Research (AHCPR) and the Health Resources and Services Administration (HRSA).

According to researchers, who were led by John M. Tilford, PhD, of Arkansas Children’s Hospital in Little Rock, the study suggests that the falling death rates are the result of improvements over time in the quality of intensive care such as better ventilation technology.

"Specialized health care for children with pediatric emergencies is a matter of life and death," says HRSA administrator Claude Earl Fox, MD, MPH. "This study shows that national standards for training and care developed through our Emergency Medical Services for Children Program are working."

The researchers also examined mortality risk by age, regardless of condition, and found that death rates declined the most for younger children.

The death rate of infants less than one month of age treated in hospital pediatric intensive care units dropped by 39%, while that of babies one to 12 months of age fell by 28%. The death rate for children overall treated in hospital pediatric intensive care units during the period declined by 15%.

The full text of the article is available in the October 1998 issue of Critical Care Medicine.