Download PDF
J Pediatr Intensive Care 2018; 07(01): 001-006
DOI: 10.1055/s-0037-1601337
Original Article
Georg Thieme Verlag KG Stuttgart · New York

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

Angela Hui Ping Kirk
1   Division of Nursing, KK Women's and Children's Hospital, Singapore
,
Qian Wen Sng
1   Division of Nursing, KK Women's and Children's Hospital, Singapore
,
Lu Qin Zhang
1   Division of Nursing, KK Women's and Children's Hospital, Singapore
,
Judith Ju Ming Wong
2   Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore
,
Janil Puthucheary
3   Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore
4   Office of Clinical Sciences, Duke-NUS School of Medicine, Singapore
,
Jan Hau Lee
3   Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore
4   Office of Clinical Sciences, Duke-NUS School of Medicine, Singapore
› Author Affiliations
Further Information

Publication History

05 January 2017

18 February 2017

Publication Date:
20 March 2017 (online)

    Permissions and Reprints

Abstract

Long-stay patients in the PICU have a higher risk of mortality as compared with non–long-stay patients. We aim to describe mortality and characteristics of long-stay patients and to determine the risk factors for mortality in these children. Total 241 (4.8%) long-stay admissions were identified. Mortality of long-stayers was 48/241 (20%). Higher severity-of-illness score at admission, need for organ support therapies, number of nosocomial infections, and bloodstream nosocomial infection were associated with a higher mortality in long-stay patients in the PICU. Based on multivariate analysis, oncologic diagnosis as a preexisting comorbidity is a strong independent predictor of mortality for long-stay patients.

Keywords

children - pediatrics - intensive care - length of stay - outcome - long-stay - mortality

Note

This investigation was approved by the SingHealth institutional review board, without need for informed consent. The authors declare that they have no competing interests. None of the authors received any funding for this study.


 

  • References

  • 1 Conlon NP, Breatnach C, O'Hare BP, Mannion DW, Lyons BJ. Health-related quality of life after prolonged pediatric intensive care unit stay. Pediatr Crit Care Med 2009; 10 (01) 41-44
    CrossrefPubMedGoogle Scholar
  • 2 Naghib S, van der Starre C, Gischler SJ, Joosten KF, Tibboel D. Mortality in very long-stay pediatric intensive care unit patients and incidence of withdrawal of treatment. Intensive Care Med 2010; 36 (01) 131-136
    CrossrefPubMedGoogle Scholar
  • 3 Namachivayam P, Taylor A, Montague T. , et al. Long-stay children in intensive care: long-term functional outcome and quality of life from a 20-yr institutional study. Pediatr Crit Care Med 2012; 13 (05) 520-528
    CrossrefPubMedGoogle Scholar
  • 4 Marcin JP, Slonim AD, Pollack MM, Ruttimann UE. Long-stay patients in the pediatric intensive care unit. Crit Care Med 2001; 29 (03) 652-657
    CrossrefPubMedGoogle Scholar
  • 5 van der Heide P, Hassing MB, Gemke RJ. Characteristics and outcome of long-stay patients in a paediatric intensive care unit: a case-control study. Acta Paediatr 2004; 93 (08) 1070-1074
    CrossrefPubMedGoogle Scholar
  • 6 González-Cortés R, López-Herce-Cid J, García-Figueruelo A, Tesorero-Carcedo G, Botrán-Prieto M, Carrillo-Álvarez A. [Prolonged stay in pediatric intensive care units: mortality and healthcare resource consumption] [in Spanish]. Med Intensiva 2011; 35 (07) 417-423 (English Edition)
    CrossrefPubMedGoogle Scholar
  • 7 Pollack MM, Wilkinson JD, Glass NL. Long-stay pediatric intensive care unit patients: outcome and resource utilization. Pediatrics 1987; 80 (06) 855-860
    PubMedGoogle Scholar
  • 8 Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002; 165 (07) 867-903
    CrossrefPubMedGoogle Scholar
  • 9 Mitt P, Metsvaht T, Adamson V. , et al. Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit. J Hosp Infect 2014; 86 (02) 95-99
    CrossrefPubMedGoogle Scholar
  • 10 Centers for Disease Control and Prevention. CAUTI. 2016 http://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf . Accessed May 24, 2016
    PubMedGoogle Scholar
  • 11 Wells PS, Anderson DR, Rodger M. , et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med 2003; 349 (13) 1227-1235
    CrossrefPubMedGoogle Scholar
  • 12 Nakagawa TA, Ashwal S, Mathur M, Mysore M. ; Society of Critical Care Medicine; Section on Critical Care and Section on Neurology of American Academy of Pediatrics; Child Neurology Society Clinical report—guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations. Pediatrics 2011; 128: 720-740
    CrossrefPubMedGoogle Scholar
  • 13 Heying R, Schneider DT, Körholz D, Stannigel H, Lemburg P, Göbel U. Efficacy and outcome of intensive care in pediatric oncologic patients. Crit Care Med 2001; 29 (12) 2276-2280
    CrossrefPubMedGoogle Scholar
  • 14 Ali AM, Sayed HA, Mohammed MM. The outcome of critically ill pediatric cancer patients admitted to the pediatric intensive care unit in a tertiary university oncology center in a developing country: a 5-year experience. J Pediatr Hematol Oncol 2016; 38 (05) 355-359 ; [Epub ahead of print]
    CrossrefPubMedGoogle Scholar
  • 15 Maniscalco J, Ottolini M, Turenne WM, Chavanu K, Slonim AD. Long-stay patients in academic children's hospitals. J Clin Outcomes Manag 2006; 13: 270-278
    PubMedGoogle Scholar
  • 16 Moore P, Kerridge I, Gillis J, Jacobe S, Isaacs D. Withdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literature. J Paediatr Child Health 2008; 44 (7-8): 404-408
    CrossrefPubMedGoogle Scholar
  • 17 Longden JV, Mayer AP. Family involvement in end-of-life care in a paediatric intensive care unit. Nurs Crit Care 2007; 12 (04) 181-187
    CrossrefPubMedGoogle Scholar