A comparative analysis of intensive care outcomes in children with complex chronic conditions and acute illnesses: A single-center prospective observational cohort from Indonesia
Saptadi Yuliarto, Nabila Khairani, Takhta Khalasha, Charity Monica, Kurniawan Taufiq KadafiAbstract
Background:
Children with complex chronic conditions (CCCs) – multiorgan disorders lasting at least 12 months – represent a growing share of pediatric intensive care unit (PICU) admissions and are often linked to prolonged hospitalization and higher mortality, especially in resource-limited settings. This study aimed to compare the clinical characteristics and outcomes of children with CCC with those of children with acute illness.
Subjects and Methods:
We conducted a prospective cohort study in the PICU of a tertiary hospital between August and October 2024, including all admissions except those who were dead on arrival or had a PICU stay of <24 h. Demographics, illness severity, and outcomes – ventilator-free days (VFDs), PICU-free days (PFD), 90-day readmission, and 28-day mortality – were compared using Chi-square and Mann–Whitney
Results:
We analyzed 80 patients: 63 (79%) with CCC and 17 (21%) with acute illness. Groups did not differ in sex, age, or illness onset, but baseline Pediatric Logistic Organ Dysfunction-2 category distribution differed significantly, with more acute illness patients classified as moderate dysfunction (29.4% vs. 7.9%,
Conclusions:
Children with CCC had numerically higher 28-day mortality and more frequent 90-day readmissions and prolonged PICU stays than children with acute nonchronic illness.