Evaluation of cases hospitalised in paediatric intensive care and the factors affecting mortality due to acute myocarditis

Abstract

Objectives: This study aimed to identify the factors associated with mortality and the duration of hospital and paediatric intensive care unit (PICU) stay in children diagnosed with acute myocarditis (AM). Methods: This multicentre retrospective study was conducted across 11 PICUs over an 18-month period. Cases were classified as survivors or non-survivors, and comparisons were made between the two groups. The factors influencing hospital and PICU length of stay (LOS) were analysed only among survivors. Results: A total of 90 patients were included, of whom 54 (60%) were female. The PICU mortality rate was 21.1%. Significant differences between survivors and non-survivors were observed in sex distribution, presence of chronic disease, presenting symptoms (exercise intolerance and vomiting), hypoxia, hypotension, and tachycardia at admission, hospital LOS, intensive care scores, initial and peak pro-brain natriuretic peptide levels, initial and final left ventricular ejection fraction (LVEF), presence of cardiogenic shock, need for respiratory support, and use of inotropic agents (p < 0.05). Among survivors, younger age and lower initial LVEF were associated with longer PICU LOS, whereas higher intensive care scores and elevated cardiac biomarker levels showed positive correlations with both hospital and PICU LOS. Conclusion: In paediatric patients with AM, younger age, lower initial LVEF, and higher intensive care scores and cardiac biomarker values are associated with prolonged PICU stay. Early identification of these factors may help predict clinical course and optimise intensive care management.