Long-stay patients in pediatric intensive care units. Five-years, 2-points, cross-sectional study
Mohamad-Hani A Temsah1, Ayman A Al-Eyadhy, Fahad M Al-Sohime
1Pediatric Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. mtemsah@ksu.edu.sa.
Insights
The prevalence of long-stay patients (LSP) in pediatric intensive care units (PICUs) decreased between 2014 and 2019. Addressing medical and social factors is key to optimizing PICU resource utilization.
Area of Science:
- Pediatric Critical Care Medicine
- Healthcare Resource Management
- Epidemiology
Background:
- Long-stay patients (LSP) significantly impact pediatric intensive care unit (PICU) resource utilization.
- Understanding trends in LSP is crucial for optimizing critical care services.
Purpose of the Study:
- To investigate the changing patterns of long-stay patients (LSP) in PICUs.
- To identify factors contributing to extended stays and resource consumption.
Main Methods:
- A 2-point cross-sectional study conducted in Riyadh, Saudi Arabia, from 2014 to 2019.
- Included children with PICU stays exceeding 21 days across multiple PICUs and SCICUs.
Main Results:
- LSP prevalence decreased from 32% in 2014 to 23.4% in 2019.
- Common diagnoses included neuromuscular/cardiac disease with respiratory compromise; ventilator-associated pneumonia was a frequent complication.
- Mechanical ventilation, antibiotics, and blood products were heavily utilized; medical reasons and social factors contributed to extended stays.
Conclusions:
- Decreasing LSP occupancy is a positive trend, but long stays still strain critical care resources.
- Further engagement with healthcare leaders and families is essential to maximize resource utilization and address underlying causes of extended stays.
Objectives:
To explore the changing patterns of long-stay patients (LSP) to improve the utilization of pediatric intensive care units (PICUs) resources.
Methods:
This is a 2-points cross-sectional study (5 years apart; 2014-2019) conducted among PICUs and SCICUs in Riyadh, Saudi Arabia. Children who have stayed in PICU for more than 21 days were included.
Results:
Out of the 11 units approached, 10 (90%) agreed to participate. The prevalence of LSP in all these hospitals decreased from 32% (48/150) in 2014 to 23.4% (35/149) in 2019. The length of stay ranged from 22 days to 13.5 years. The majority of LSP had a neuromuscular or cardiac disease and were admitted with respiratory compromise. Ventilator-associated pneumonia was the most prevalent complication (37.5%). The most commonly used resources were mechanical ventilation (93.8%), antibiotics (60.4%), and blood-products transfusions (35.4%). The most common reason for the extended stay was medical reasons (51.1%), followed by a lack of family resources (26.5%) or lack of referral to long-term care facilities (22.4%).
Conclusion:
A long-stay is associated with significant critical care bed occupancy, complications, and utilization of resources that could be otherwise utilized as surge capacity for critical care services. Decreasing occupancy in this multicenter study deserves further engagement of the healthcare leaders and families to maximize the utilization of resources.
Related Concept Videos
01:26Longitudinal Studies
02:20Longitudinal Research
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...