Related Experiment Videos
Evaluation of paediatric intensive care in a regional centre
Insights
This UK paediatric intensive care unit study found that while most admissions aimed for cure, nearly 19% received palliative care. Resource use was highest for the sickest infants, with mortality inversely related to sickness severity.
Area of Science:
- Pediatric Intensive Care
- Critical Care Medicine
- Healthcare Management
Background:
- Paediatric intensive care units (PICUs) manage critically ill children.
- Understanding patient demographics, treatment goals, and resource utilization is crucial for PICU operations and quality improvement.
Purpose of the Study:
- To prospectively evaluate admissions to a UK multidisciplinary PICU.
- To analyze therapeutic intention, sickness levels, age, resource utilization, and outcomes.
- To establish a basis for medical audit and inter-unit comparisons.
Main Methods:
- Prospective evaluation of 162 consecutive admissions to a UK PICU.
- Data collected on therapeutic intention, sickness severity, patient age, resource use, and survival.
- Analysis of factors influencing resource utilization and mortality.
Main Results:
- 62.3% of admissions aimed for cure; 18.5% received palliative care.
- 50% of children were physiologically unstable; 62.9% were 12 months or younger.
- Resource utilization was highest for the sickest patients, infants ≤1 month, and non-survivors.
- Overall mortality was 17.9%, inversely related to sickness severity.
Conclusions:
- PICU resource utilization is driven by patient acuity and outcomes, not therapeutic intention.
- Mortality in the PICU is not influenced by age or therapeutic intent but is linked to sickness severity.
- This data is essential for internal medical audits and benchmarking PICU standards.
Abstract:
All 162 consecutive admissions to a multidisciplinary paediatric intensive care unit in the UK have been prospectively evaluated in terms of therapeutic intention, sickness levels, age, utilisation of resources, and outcome. For 101 (62.3%) of the children admitted the aim of treatment was to cure the condition but for 30 (18.5%) ultimately only a palliative option was available. Five children were admitted to avail of specialised monitoring facilities. One half of the children admitted were physiologically unstable. The majority (102, 62.9%) were age 12 months or less. Resource utilisation, which was not affected by therapeutic intention, was greatest for the sickest patients, those age 1 month or less and non-survivors. Mortality rate overall was 17.9%. Mortality was unaffected by age and therapeutic intention and was inversely related to level of sickness. The information provided by this study forms a basis for medical audit within the unit and is essential for meaningful comparisons of standards of care and outcome with other units.