Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 8 2021 09 22 491 498 EN Pranab Dey Department of Paediatrics, R.G Kar Medical College, West Bengal University of Health Sciences, Kolkata, West Bengal, India Arindam Ghosh Department of Paediatrics, Midnapore Medical College, West Bengal University of Health Sciences, West Bengal, India Sunil Hemram Department of Community Medicine, IPGMER and SSKM Hospital, West Bengal University of Health Sciences, Kolkata, India Meghna Mukherjee Department of Community Medicine, IPGMER and SSKM Hospital, West Bengal University of Health Sciences, Kolkata, India Saba Annigeri Department of Paediatrics, Midnapore Medical College, West Bengal University of Health Sciences, West Bengal, India Anupama Nair Department of Paediatrics, Midnapore Medical College, West Bengal University of Health Sciences, West Bengal, India 2020 11 28 2021 06 02 To capture lapses in management, active surveillance of pediatric intensive care unit (PICU) admissions should consider as an essential tool to bring a better outcome with available resources, while there is a scarcity of data from comparatively newly set up peripheral PICU in developing countries. An observational record-based cross-sectional study was conducted in a peripheral medical college PICU over one year to evaluate morbidity pattern, outcome, and predictors of mortality. Binomial logistic regression (SPSS version-25) was used for analysis. The confidence interval (CI) of Odd’s ratio was used to report the strength of association between dependent and independent variables. Pneumonia was the major cause of admission (27%), followed by septicemia (25.5%), congenital heart diseases (12.2%), bronchiolitis (6.6%), seizure disorders (8.6%), encephalitis (5%), and meningitis (4%). 51.7% were discharged, 14.6 %were referred, 3.2% were left against medical advice, and 30.4% were expired. Pneumonia (46.44%) was the most common cause of death, followed by sepsis (42.07%), congenital heart disease (15.3%), and bronchiolitis (6.01%). The mean duration of stay in PICU was five days (range 1-31 days). Patients who required ventilation (40%) or Inotropes (55.6%) had increased risk of mortality by 14 and 8 times, respectively. Age below one year, presence of bronchiolitis, pneumonia, ARDS, encephalitis, anemia, sepsis, dyselectrolytemia, and requirement of inotropes or ventilation were statistically significant risk factors for mortality (P<0.05). These predictors of morality will help to identify severe cases, prioritize resources and focus on the preventable methods in the public such as a vaccine, creating awareness about diseases, and proper referral. https://acta.tums.ac.ir/index.php/acta/article/view/8975