Thesis defence in the University of Oulu

Doctoral Candidate

Medical Doctor Elina Kyösti

Faculty and research unit

University of Oulu Graduate School, Faculty of Medicine, Department of anaesthesiology, Department of pediatrics

Field of study

Anesthesiology and intensive care

Date and time of the thesis defence

15.11.2019 12:00

Place of the thesis defence

Oulu University Hospital, lecture rooms 1 and 2

Topic of the dissertation

Long-term outcome, quality of life and socio-economic consequences of surviving pediatric intensive care

Opponent

Docent Tuula Lönnqvist, Helsinki University Hospital, Children's Hospital

Custos

Professor Tero Ala-Kokko, Oulu University hospital, Department of Anesthesiology

Pediatric intensive care in Finland is of high quality

The pediatric intensive care in Finland shows good long-term results. Most children have a good quality of life five years after intensive care. Most children also manage well even with a severe disease.

One in ten children treated in intensive care feel that their quality of life is poor. This is caused by chronic diseases that, along with treatments, place a strain on the lives of the children and their families. Every other child admitted to intensive care has a chronic disease. Neurological diseases, chromosomal alterations, cancer and long-term pain are the most common factors leading to a decreased quality of life.

Deaths are rare in pediatric intensive care units. The mortality rate for Finnish children in intensive care is only 1.9 per cent, which is among the lowest in the world. In developed countries, mortality rates for children in intensive care currently range from 1.4 to 6.5 per cent.

The mortality risk persists even after intensive care among children with a severe disease.  During the study’s five-year follow-up period, 4.8 per cent of the pediatric intensive care patients died. Children admitted to intensive care are at a fifty-fold greater risk of mortality than those who have not been admitted. Mortality is often predictable for pediatric intensive care patients with a severe disease. The most frequent causes of death for pediatric intensive care patients are neurological and metabolic diseases, and cancers.

Severe underlying diseases weaken the mental well-being of pediatric intensive care patients and make it more difficult for the child to succeed in school. The socio-economic situation of the family is also worse when their child's mental health is poor.

Lic. Med. Elina Kyösti’s doctoral dissertation study population consisted of all pediatric intensive care patients in Finland in 2009 and 2010. The mortality data were compared with the population of all other Finnish children. Survivors were sent questionnaire material regarding their health-related quality of life, psychological well-being, chronic diseases and need for regular medication and therapy as well as the socio-economic situation of the family. The questionnaire was answered by 1109 children and their families.

The study shows that pediatric intensive care in Finland is of high quality. Decreased quality of life is associated with severe underlying diseases, and when these risk groups are known, it is easier to follow up patients and provide the necessary support after intensive care.

 

Dissertation

Last updated: 8.11.2019