PICU admissions
Multivariate analysis revealed a positive association between CRP and an
increased risk of PICU admission due to respiratory failure. Studies
report an admission rate of 3-27% with variability in invasive
ventilation usage, which correlates with younger age, especially those
under 3 months. A recent study reported a PICU admission rate of 27%,
with only 3.5% requiring invasive ventilation, and 96% utilizing high
flow nasal cannula. This non-invasive ventilation method is routinely
used in the PICU and was integrated into our pediatric wards in the
middle of the study period. This may have contributed to the low rate of
PICU admission in our study of 5.5%. Although few studies have examined
the association between CRP and PICU admission, a preliminary study of
177 patients found an association between PICU admission and a mean CRP
of 3.9 mg/dL when most patients had RSV bronchiolitis. However, another
study failed to demonstrate such an association. Our study demonstrated
an association between elevated CRP and PICU admission, reflected by a
relative risk of 2.25 in a multivariable model. The suggested cutoff
value’s ability to differentiate between children admitted to PICU was
limited (Figure 3). However, we found that a cutoff value of 3.295 was
useful for children under three months old (AUC 0.68).