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Characteristics and Outcomes of Long-Stay Patients in the Pediatric Intensive Care Unit

Angela Hui Ping Kirk1, Qian Wen Sng1, Lu Qin Zhang1

  • 1Division of Nursing, KK Women's and Children's Hospital, Singapore.

Journal of Pediatric Intensive Care
|May 11, 2019
PubMed

Insights

Long-stay patients in the Pediatric Intensive Care Unit (PICU) face higher mortality risks. Key risk factors include severe illness, organ support, infections, and particularly, a pre-existing oncologic diagnosis.

Area of Science:

  • Pediatric Critical Care Medicine
  • Oncology
  • Infectious Diseases

Background:

  • Long-stay patients in the Pediatric Intensive Care Unit (PICU) are recognized as a vulnerable population.
  • These patients often have complex medical needs and prolonged hospitalizations, increasing their risk of adverse outcomes compared to short-stay patients.

Purpose of the Study:

  • To characterize the mortality rates and patient demographics of long-stay admissions in the PICU.
  • To identify specific risk factors associated with increased mortality in this high-risk group.

Main Methods:

  • Retrospective analysis of 241 long-stay admissions (4.8% of total admissions).
  • Data collection included severity-of-illness scores, organ support requirements, incidence of nosocomial infections, and pre-existing comorbidities.
  • Multivariate analysis was employed to determine independent predictors of mortality.

Main Results:

  • The overall mortality rate for long-stay patients was 20% (48 out of 241).
  • Factors significantly associated with higher mortality included higher admission severity-of-illness scores, requirement for organ support therapies, and a greater number of nosocomial infections, especially bloodstream infections.
  • Oncologic diagnosis emerged as a strong independent predictor of mortality.

Conclusions:

  • Long-stay PICU patients exhibit a substantial mortality rate.
  • Early identification of high-risk factors such as severe illness, organ dysfunction, infections, and oncologic diagnoses is crucial for targeted interventions.
  • An oncologic diagnosis is a significant independent risk factor for mortality in long-stay PICU patients, highlighting the need for specialized care pathways.

Keywords:
childrenintensive carelength of staylong-staymortalityoutcomepediatrics

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