A comparative two-cohort study of pediatric patients with long term stay in ICUs

Area of Science:

• Pediatric critical care medicine
• Healthcare resource utilization
• Patient outcomes

Background:

• Long stay admissions (LSA) in Pediatric Intensive Care Units (PICU) have been increasing over recent decades.
• Understanding the factors associated with LSA is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To identify factors associated with Pediatric Intensive Care Unit Long Stay Admissions.
• To assess healthcare resource utilization in LSA patients.
• To analyze changes in the profile of LSA patients over time.

Main Methods:

• A retrospective, observational, single-center study was conducted.
• Characteristics of LSA patients were compared between two distinct periods: 2006-2010 and 2011-2015.
• Statistical analysis was performed to identify significant differences between the two cohorts.

Main Results:

• The proportion of LSA increased from 3.9% to 5.4% between the two periods, with LSA accounting for a larger percentage of total PICU stay days (33.7% vs. 46.7%).
• The later period (2011-2015) showed increased use of non-invasive ventilation and high-flow oxygen therapy, but decreased use of arterial catheters, continuous adrenaline infusions, and hemoderivative transfusions.
• Hospital-acquired infections were more common, and mortality was higher in the earlier period (2006-2010).

Conclusions:

• Long stay admissions in PICU are increasing, leading to intensive healthcare resource utilization.
• Patients with LSA are associated with a high risk of complications and mortality.
• Changes in treatment modalities, such as increased use of respiratory support, may be influencing LSA profiles and outcomes.