Related Experiment Video
Updated: Jul 18, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018
Tim J van Hasselt1, Hari Krishnan Kanthimathinathan2, Trishul Kothari3
1Department of Population Health Sciences, University of Leicester, Leicester, LE1 7RH, UK, University Rd. t.vanhasselt@nhs.net.
Insights
Long-stay admissions in pediatric intensive care units (PICUs) are increasing, particularly for preterm-born children. These children face higher mortality and readmission rates, impacting PICU resource allocation.
Area of Science:
- Pediatric critical care medicine
- Neonatalogy
- Public health policy
Background:
- Improved survival in extreme preterm birth leads to increased childhood morbidity.
- Previous studies indicated a rise in long-stay admissions in pediatric intensive care units (PICUs).
Purpose of the Study:
- To analyze trends in long-stay admissions (≥28 days) in English PICUs for children under 2 years.
- To assess outcomes, including mortality and readmission, for long-stay PICU patients.
- To determine the proportion of preterm-born children within the long-stay PICU population.
Main Methods:
- Utilized data from the Paediatric Intensive Care Audit Network (PICANet) in England.
- Analyzed admissions for children under 2 years from January 1, 2008, to December 31, 2018.
- Conducted descriptive analysis of patient characteristics and PICU outcomes.
Main Results:
- Long-stay admissions increased from 2.7% to 4.0% between 2008 and 2018, occupying 24.2% to 33.2% of PICU bed days.
- Children born preterm constituted a significant portion of long-stay patients (33.5%), over-represented compared to the national preterm birth rate (8%).
- Long-stay patients experienced disproportionately higher mortality (24.8-26.5%) and readmission rates (76.3% for preterm-born).
Conclusions:
- Long-stay PICU admissions represent a growing challenge in England, with preterm-born children being disproportionately affected.
- These findings highlight the need for targeted research into pediatric morbidity and strategic planning for PICU services.
- The increasing burden of long-stay patients necessitates a re-evaluation of resource allocation and care pathways within pediatric intensive care.
Background:
Survival following extreme preterm birth has improved, potentially increasing the number of children with ongoing morbidity requiring intensive care in childhood. Previous single-centre studies have suggested that long-stay admissions in paediatric intensive care units (PICUs) are increasing. We aimed to examine trends in long-stay admissions (≥28 days) to PICUs in England, outcomes for this group (including mortality and PICU readmission), and to determine the contribution of preterm-born children to the long-stay population, in children aged <2 years.
Methods:
Data was obtained from the Paediatric Intensive Care Audit Network (PICANet) for all children <2 years admitted to National Health Service PICUs from 1/1/2008 to 31/12/2018 in England. We performed descriptive analysis of child characteristics and PICU outcomes.
Results:
There were 99,057 admissions from 67,615 children. 2,693 children (4.0%) had 3,127 long-stays. Between 2008 and 2018 the annual number of long-stay admissions increased from 225 (2.7%) to 355 (4.0%), and the proportion of bed days in PICUs occupied by long-stay admissions increased from 24.2% to 33.2%. Of children with long-stays, 33.5% were born preterm, 53.5% were born at term, and 13.1% had missing data for gestational age. A considerable proportion of long-stay children required PICU readmission before two years of age (76.3% for preterm-born children). Observed mortality during any admission was also disproportionately greater for long-stay children (26.5% for term-born, 24.8% for preterm-born) than the overall rate (6.3%).
Conclusions:
Long-stays accounted for an increasing proportion of PICU activity in England between 2008 and 2018. Children born preterm were over-represented in the long-stay population compared to the national preterm birth rate (8%). These results have significant implications for future research into paediatric morbidity, and for planning future PICU service provision.
