Pediatric admissions that include intensive care: a population-based study
Ibinabo Ibiebele1,2, Charles S Algert3,4, Jennifer R Bowen3,5
1Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia. ibinabo.ibiebele@sydney.edu.au.
Insights
Most pediatric intensive care unit admissions occur in specialist units, but a significant number of children are admitted to general hospital intensive care units. Including these general intensive care unit admissions provides a comprehensive overview of pediatric critical care.
Area of Science:
- Critical Care Medicine
- Pediatric Health
- Hospital Administration
Background:
- Registry-based studies often exclude pediatric intensive care admissions outside of children's hospitals.
- This exclusion may lead to an incomplete understanding of pediatric critical care utilization.
Purpose of the Study:
- To compare pediatric admissions to specialist pediatric intensive care units (PICU) versus intensive care units (ICU) in general hospitals.
- To evaluate the characteristics and outcomes of pediatric patients admitted to different types of intensive care settings.
Main Methods:
- Population-based record linkage cohort study using Australian hospital and death data (2010-2013).
- Included post-neonatal pediatric hospital admissions with ICU stay, excluding neonatal ICU admissions.
Main Results:
- 1.5% of 498,466 pediatric hospitalizations involved ICU admission (93.7% PICU, 6.3% general ICU).
- General ICU admissions involved older children, rural populations, acute conditions (asthma, injury, diabetes), and had shorter ICU stays.
- General ICU patients were less likely to have chronic conditions or receive advanced interventions like ventilation or parenteral nutrition, and had lower mortality.
Conclusions:
- A notable proportion of pediatric intensive care occurs in general hospital ICUs.
- Comprehensive analysis of pediatric critical care requires including admissions from both specialist PICUs and general hospital ICUs.
Background:
Pediatric admissions to intensive care outside children's hospitals are generally excluded from registry-based studies. This study compares pediatric admission to specialist pediatric intensive care units (PICU) with pediatric admissions to intensive care units (ICU) in general hospitals in an Australian population.
Methods:
We undertook a population-based record linkage cohort study utilizing longitudinally-linked hospital and death data for pediatric hospitalization from New South Wales, Australia, 2010-2013. The study population included all new pediatric, post-neonatal hospital admissions that included time in ICU (excluding neonatal ICU).
Results:
Of 498,466 pediatric hospitalizations, 7525 (1.5%) included time in an intensive care unit - 93.7% to PICU and 6.3% to ICU in a general (non-PICU) hospital. Non-PICU admissions were of older children, in rural areas, with shorter stays in ICU, more likely admitted for acute conditions such as asthma, injury or diabetes, and less likely to have chronic conditions, receive continuous ventilatory support, blood transfusion, parenteral nutrition or die.
Conclusions:
A substantial proportion of children are admitted to ICUs in general hospitals. A comprehensive overview of pediatric ICU admissions includes these admissions and the context of the total hospitalization.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
05:56Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
Published on: September 6, 2024
Related Concept Videos
01:25What is Population Genetics?
00:30What are Populations and Communities?
02:04Conservation of Small Populations
00:57Population Growth
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care