| Summary: | Background: Prematurity is a major risk factor for morbidity and mortality in children.
Rehospitalisation with paediatric intensive care unit (PICU) admission constitutes
significant morbidity. There is a paucity of literature regarding rehospitalisations of
premature infants in South Africa.
Objective: To describe the outcomes, clinical course and characteristics of premature
infants admitted to a South African PICU, and to identify any predictors of mortality.
Methods: This prospective observational study analysed unplanned PICU admissions of
premature and ex-premature infants in the first six months of life, over a six-month
period. The primary and secondary outcomes were mortality and length of PICU stay,
respectively. Data were analysed using standard descriptive and inferential statistics.
Results: 29 infants (65% male; median (IQR) birth weight (BW) and gestational age (GA)
1715 (1130 - 2340) g and 32 (29 - 34) weeks respectively) in 33 admissions were included.
Five (17.2%) infants died in PICU.
Apnoea (39.4%), respiratory failure (24.2%) and shock (24.2%) were the commonest
reasons for PICU admission, secondary to pneumonia (33.3%), sepsis (27.3%) and
meningitis (12.1%). 72.4% of infants were mechanically ventilated and 48.3% received
blood transfusions.
Higher revised Paediatric Risk of Mortality (PIM2) score (p = 0.03), inotrope use (p <
0.0001), longer duration of mechanical ventilation (p = 0.03), and cardiac arrest in PICU (p
< 0.0001) were associated with mortality on univariate analysis with no independent
predictors of mortality.
Conclusion: Infections leading to apnoea, respiratory failure and shock are common
indications for PICU readmission in premature infants. Mechanical ventilation and blood
transfusion were frequently required.
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