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Immediate and 5-year cumulative outcome after paediatric intensive care in Sweden

N Gullberg1, H Kalzén, O Luhr

  • 1Department of Paediatric Anaesthesia and Intensive Care, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden.

Acta Anaesthesiologica Scandinavica
|October 9, 2008
PubMed

Insights

Swedish pediatric intensive care has low immediate mortality. However, patients discharged alive from intensive care units (ICUs) face a significantly higher 5-year mortality risk, suggesting a need for centralized care evaluation.

Area of Science:

  • Pediatric critical care medicine
  • Public health surveillance
  • Epidemiology

Background:

  • Limited data exists on pediatric intensive care in Sweden.
  • Understanding pediatric intensive care utilization and outcomes is crucial for healthcare planning.

Purpose of the Study:

  • To analyze pediatric intensive care admissions, diagnoses, and length-of-stay (LOS) in Sweden (1998-2001).
  • To compare pediatric intensive care units (PICUs) with adult intensive care units (ICUs).
  • To assess immediate and 5-year mortality rates for pediatric intensive care patients.
  • To determine the actual consumption of pediatric intensive care services.

Main Methods:

  • A national multicenter, ambidirectional cohort study included children aged 6 months to 16 years admitted to intensive care.
  • Data for infants (1-6 months) were collected in PICUs.
  • Survival data were obtained from the National Files of Registration 5 years post-admission.

Main Results:

  • 8,063 admissions (6,661 patients) were identified, with an admission rate of 1.59 per 1000 children annually.
  • Median LOS was 1 day, with an ICU mortality of 2.1% and a 5-year cumulative mortality of 5.6%.
  • Only 44% of pediatric intensive care admissions occurred in dedicated PICUs.

Conclusions:

  • Sweden exhibits low immediate intensive care unit mortality, comparable between PICUs and adult ICUs.
  • Patients surviving intensive care showed a 20-fold increased mortality risk over 5 years compared to controls.
  • Less than half of Swedish pediatric intensive care patients were treated in PICUs, prompting investigation into potential benefits of care centralization.
Abstract

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