Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018.

Autor: van Hasselt TJ; Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK, University Rd. t.vanhasselt@nhs.net., Kanthimathinathan HK; Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK., Kothari T; Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK., Plunkett A; Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK., Gale C; School of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, London, UK., Draper ES; Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK, University Rd., Seaton SE; Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK, University Rd.
Jazyk: angličtina
Zdroj: BMC pediatrics [BMC Pediatr] 2023 Aug 24; Vol. 23 (1), pp. 421. Date of Electronic Publication: 2023 Aug 24.
DOI: 10.1186/s12887-023-04254-0
Abstrakt: Background: Survival following extreme preterm birth has improved, potentially increasing the number of children with ongoing morbidity requiring intensive care in childhood. Previous single-centre studies have suggested that long-stay admissions in paediatric intensive care units (PICUs) are increasing. We aimed to examine trends in long-stay admissions (≥28 days) to PICUs in England, outcomes for this group (including mortality and PICU readmission), and to determine the contribution of preterm-born children to the long-stay population, in children aged <2 years.
Methods: Data was obtained from the Paediatric Intensive Care Audit Network (PICANet) for all children <2 years admitted to National Health Service PICUs from 1/1/2008 to 31/12/2018 in England. We performed descriptive analysis of child characteristics and PICU outcomes.
Results: There were 99,057 admissions from 67,615 children. 2,693 children (4.0%) had 3,127 long-stays. Between 2008 and 2018 the annual number of long-stay admissions increased from 225 (2.7%) to 355 (4.0%), and the proportion of bed days in PICUs occupied by long-stay admissions increased from 24.2% to 33.2%. Of children with long-stays, 33.5% were born preterm, 53.5% were born at term, and 13.1% had missing data for gestational age. A considerable proportion of long-stay children required PICU readmission before two years of age (76.3% for preterm-born children). Observed mortality during any admission was also disproportionately greater for long-stay children (26.5% for term-born, 24.8% for preterm-born) than the overall rate (6.3%).
Conclusions: Long-stays accounted for an increasing proportion of PICU activity in England between 2008 and 2018. Children born preterm were over-represented in the long-stay population compared to the national preterm birth rate (8%). These results have significant implications for future research into paediatric morbidity, and for planning future PICU service provision.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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