Acute and chronic paediatric intensive care patients: current trends and perspectives on resource utilization

Acute and chronic paediatric intensive care patients: current trends and perspectives on resource utilization

Briassoulis G; Filippou O; Natsi L; Mavrikiou M; Hatzis T

Monthly Journal Of The Association Of Physicians

2004

Child; Female; Humans; infant; Male; Intensive Care Units; Hospital Mortality; Prospective Studies; Length of Stay; Respiration; Severity of Illness Index; Analysis of Variance; adolescent; Preschool; infant; Newborn; Pediatric/utilization; ICU Decision Making; Greece; Acute Disease/mortality/therapy; Artificial/methods; Chronic Disease/mortality/therapy; Health Resources/trends/utilization

BACKGROUND: Advances in paediatric critical care have resulted in increased survival of critically ill patients, many of whom require long-term ventilation as a means of life support. AIM: To determine current trends in resource utilization, and problems in the care of acute and chronic paediatric intensive care patients. DESIGN: Open observational study. METHODS: We evaluated consecutive admissions (n = 1629) to a 10-bed paediatric intensive care unit (PICU) over a 5-year period. Three previously defined criteria for resource utilization were used: mean length of stay (LOS); length of mechanical ventilation (LOMV); and LOMV/LOS ratio. RESULTS: A total of 10 310 patient bed days and 5223 ventilator days were used. Mean LOS increased from 5.3 +/- 12 days in 1998 to 8.7 +/- 27 days in 2001 (p 2 weeks (n = 320, 20%) used 55% of LOS and 57% of LOMV, in contrast to the 1298 (80%) hospitalized for 3 months (11, 0.7%) consumed 17% of LOS and 23% of LOMV. Five of these (45%) were eventually discharged home, two on ventilators. CONCLUSION: The increasing trend of occupation of PICU bed and ventilator days by critically ill children may be related to the increasing trend for hospitalization of chronic care patients. Severity scoring systems were predictive of resource consumption, but not of the overall trend in mortality rate.

2004

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