XXXX : a pediatric experience over 20 years.

@entity1 @entity2313 @entity295 @entity1503 @entity358 @entity810 @entity299
BACKGROUND: @entity810 in @entity1 is a catastrophic, life-threatening event. OBJECTIVE: To compare and contrast 2 decades of data, analyzing the underlying causes, associated multiple organ system failures, outcome of dialysis procedures, and other variables of interest. DESIGN: Retrospective examination of clinical data collected between January 1, 1979, and December 31, 1998. SETTING: Regional health care center in the mid-Atlantic area. @entity1 : Two hundred twenty-eight @entity1 , aged from 1 day to 18 years, had @entity810 and were referred to a pediatric nephrology service. MAIN OUTCOME MEASURES: Characteristics, percentage of mortality, intensive care unit admission, procedures, and other variables and causes of @entity810 . RESULTS: The total number of cases analyzed represented 7% of all @entity1 presented to the pediatric nephrology service. Sex distribution, ethnicity, and survival statistics were unchanged between both decades. The overall survival rate was 73%. One hundred fifty-four @entity1 (68%) were admitted to the pediatric intensive care unit. The following 106 acute extracorporeal procedures were performed on 93 @entity1 (41%): 12 @entity1 received extracorporeal membrane oxygenation, 52 @entity1 underwent peritoneal dialysis, 32 underwent hemodialysis, 3 @entity1 received continuous venovenous hemofiltration, and 7 @entity1 received continuous arteriovenous hemofiltration. @entity295 and burns, other leading causes of @entity810 in the first decade, are replaced in the second decade by @entity1503 and @entity358 . CONCLUSIONS: @entity810 following repair of @entity299 remains unchanged as a leading risk factor of mortality in both decades. Three organ system failures were associated with more than a 50% mortality rate. Predialysis low serum @entity2313 concentrations emerged as a significant copredictor of mortality.
