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An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa
Background Many critically ill children in South Africa are cared for in regional hospitals by general Paediatricians. Critically ill adults and children are usually cared for in the same units. There is limited data on the numbers of children admitted and the outcomes of these children. Objective T...
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| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2021
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| _version_ | 1867613253422546944 |
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| access_status_str | Open Access |
| author | Vosloo, Ruan |
| author2 | Salie, Shamiel |
| author_browse | Salie, Shamiel Vosloo, Ruan |
| author_facet | Salie, Shamiel Vosloo, Ruan |
| author_sort | Vosloo, Ruan |
| collection | Thesis |
| description | Background Many critically ill children in South Africa are cared for in regional hospitals by general Paediatricians. Critically ill adults and children are usually cared for in the same units. There is limited data on the numbers of children admitted and the outcomes of these children. Objective To describe the patient profile and outcomes of children admitted to a general high care unit (HCU) in a regional hospital in the Western Cape, South Africa. Methods This was a retrospective descriptive study of all children admitted to the HCU of George Regional Hospital during a one year period (2016). Demographic data, HIV, anthropometric data, immunisation status, diagnoses, medical interventions, length of stay, death or survival, and referral data to the tertiary paediatric intensive care unit (PICU) were collected. The PIM3 score and Standardized Mortality Ratio (SMR) was calculated. Results Thirty percent (144/468) of the HCU admissions were children. Most (70%) were admitted after hours. Half were under 9 months (range 3 days to 149 months). Sixty-five percent of the children required respiratory support and 45% needed inotropic support. Twenty percent of the children were transferred to the PICU. Twelve children (8,5%) died with most deaths (75%) occurring at regional level. Half of the deaths were due to sepsis with pneumonia (25%) and diarrhoea with shock (25%) accounting for the rest. The cumulative PIM3 score was 9.049 (95%CI 6.430-11.668) with an SMR of 1.326 (95%CI 1.028-1.866) observed. Conclusion Critically ill children accounted for a third of HCU admissions. Most children needed medical interventions. These require specific training and equipment that are often lacking. After hours admissions also put strain on limited staff. Most children were successfully discharged demonstrating a good outcome. This was achievable with good channels of communication and transport to a tertiary PICU. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/33077 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:12.104Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/33077 An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa Vosloo, Ruan Salie, Shamiel Breytenbach, Willem Paediatrics and Child Health Background Many critically ill children in South Africa are cared for in regional hospitals by general Paediatricians. Critically ill adults and children are usually cared for in the same units. There is limited data on the numbers of children admitted and the outcomes of these children. Objective To describe the patient profile and outcomes of children admitted to a general high care unit (HCU) in a regional hospital in the Western Cape, South Africa. Methods This was a retrospective descriptive study of all children admitted to the HCU of George Regional Hospital during a one year period (2016). Demographic data, HIV, anthropometric data, immunisation status, diagnoses, medical interventions, length of stay, death or survival, and referral data to the tertiary paediatric intensive care unit (PICU) were collected. The PIM3 score and Standardized Mortality Ratio (SMR) was calculated. Results Thirty percent (144/468) of the HCU admissions were children. Most (70%) were admitted after hours. Half were under 9 months (range 3 days to 149 months). Sixty-five percent of the children required respiratory support and 45% needed inotropic support. Twenty percent of the children were transferred to the PICU. Twelve children (8,5%) died with most deaths (75%) occurring at regional level. Half of the deaths were due to sepsis with pneumonia (25%) and diarrhoea with shock (25%) accounting for the rest. The cumulative PIM3 score was 9.049 (95%CI 6.430-11.668) with an SMR of 1.326 (95%CI 1.028-1.866) observed. Conclusion Critically ill children accounted for a third of HCU admissions. Most children needed medical interventions. These require specific training and equipment that are often lacking. After hours admissions also put strain on limited staff. Most children were successfully discharged demonstrating a good outcome. This was achievable with good channels of communication and transport to a tertiary PICU. 2021-03-03T01:24:59Z 2021-03-03T01:24:59Z 2020 2021-03-02T19:05:15Z Master Thesis Masters MMed http://hdl.handle.net/11427/33077 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Paediatrics and Child Health Vosloo, Ruan An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| thesis_degree_str | Master's |
| title | An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| title_full | An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| title_fullStr | An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| title_full_unstemmed | An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| title_short | An Assessment of Critically Ill Children admitted to a General High Care Unit in a Regional Hospital in the Western Cape, South Africa |
| title_sort | assessment of critically ill children admitted to a general high care unit in a regional hospital in the western cape south africa |
| topic | Paediatrics and Child Health |
| url | http://hdl.handle.net/11427/33077 |
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