DefinePK

Abstract

Background: Pediatric neurological disorders contribute significantly to morbidity and mortality, particularly in developing countries where data on their prevalence and outcomes is limited. This study aims to characterize the clinical profile and outcomes of children with neurological illness admitted to a pediatric intensive care unit (PICU) in Pakistan. Methods: This was a prospective, single-center study conducted from December 2024 to May 2025 at the PICU of the National Institute of Child Health, Karachi. Children aged 1 month to 16 years with a primary neurological diagnosis were included. Data on demographics, diagnosis (categorized by ICD-9), resource utilization (e.g., mechanical ventilation), and outcomes (survival, length of stay) were collected. Descriptive statistics and bivariate analysis were performed. Results: Of 465 total PICU admissions, 94 (20.22%) had a primary neurological diagnosis. The mean age was 4.92 ± 3.79 years, with a male predominance (63.8%). Infectious/Inflammatory disorders were the most common diagnosis (66.0%), followed by Neuromuscular diseases (17.0%). The overall mortality rate was 47.9%. A high proportion of patients required mechanical ventilation (90.4%), which was significantly associated with mortality (P=0.020). The mean PICU length of stay was 10.03 ± 7.36 days. Lumbar puncture was performed in 73.4% and MRI in 54.3% of patients, while EEG utilization was low (6.4%). Conclusion: Primary neurological illness accounts for a substantial proportion of PICU admissions in this setting and is associated with an alarmingly high mortality rate, primarily driven by infectious etiologies. The need for mechanical ventilation serves as a key predictor of poor outcome. These findings highlight the urgent need for enhanced public health interventions to prevent CNS infections and improved neurocritical care infrastructure and training to reduce mortality and morbidity in this vulnerable population.