Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study
IntroductionChronic critically ill patients (CCI) in pediatric intensive care unit (PICU) are at risk of negative health outcomes, and account for a considerable amount of ICU resources. This study aimed to (a) describe the prevalence of CCI children, (b) compare their clinical characteristics and I...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1194833/full |
| _version_ | 1797795088162619392 |
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| author | Chantal Grandjean Chantal Grandjean Marie-Hélène Perez Marie-Hélène Perez Anne-Sylvie Ramelet Anne-Sylvie Ramelet The OCToPuS Consortium Anne-Laure Lauria Angelo Polito Nathalie Bochaton Daniel Trachsel Mark Marston Silvia Schnidrig Tilman Humpl Bjarte Rogdo Ellen Wild Thomas Neuhaus Sandra Stalder Barbara Brotschi Franziska von Arx Anna-Barbara Schlüer Thomas Riedel Pascale Van Kleef |
| author_facet | Chantal Grandjean Chantal Grandjean Marie-Hélène Perez Marie-Hélène Perez Anne-Sylvie Ramelet Anne-Sylvie Ramelet The OCToPuS Consortium Anne-Laure Lauria Angelo Polito Nathalie Bochaton Daniel Trachsel Mark Marston Silvia Schnidrig Tilman Humpl Bjarte Rogdo Ellen Wild Thomas Neuhaus Sandra Stalder Barbara Brotschi Franziska von Arx Anna-Barbara Schlüer Thomas Riedel Pascale Van Kleef |
| author_sort | Chantal Grandjean |
| collection | DOAJ |
| description | IntroductionChronic critically ill patients (CCI) in pediatric intensive care unit (PICU) are at risk of negative health outcomes, and account for a considerable amount of ICU resources. This study aimed to (a) describe the prevalence of CCI children, (b) compare their clinical characteristics and ICU resources use with non-CCI children, and (c) identify associated risk factors of CCI.MethodsA retrospective national registry study including 2015–2017 data from the eight Swiss PICUs of five tertiary and three regional hospitals, admitting a broad case-mix of medical and surgical patients, including pre- and full-term infants. CCI patients were identified using an adapted definition: PICU length of stay (LOS) ≥8 days and dependence on ≥1 PICU technology.ResultsOut of the 12,375 PICU admissions, 982 (8%) were CCI children and compared to non-CCI children, they were younger (2.8 vs. 6.7 months), had more cardiac conditions (24% vs. 12%), and higher mortality rate (7% vs. 2%) (p < 0.001). Nursing workload was higher in the CCI compared to the non-CCI group (22 [17–27]; 21 [16–26] respectively p < 0.001). Factors associated with CCI were cardiac (aOR = 2.241) and neurological diagnosis (aOR = 2.062), surgery (aORs between 1.662 and 2.391), ventilation support (aOR = 2.278), high mortality risk (aOR = 1.074) and agitation (aOR = 1.867).Conclusionthe results confirm the clinical vulnerability and the complexity of care of CCI children as they were defined in our study. Early identification and adequate staffing is required to provide appropriate and good quality care. |
| first_indexed | 2024-03-13T03:12:35Z |
| format | Article |
| id | doaj.art-0f666a0d34144b69ab1dcc0a7de3d2a9 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T03:12:35Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-0f666a0d34144b69ab1dcc0a7de3d2a92023-06-26T10:15:25ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-06-011110.3389/fped.2023.11948331194833Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry studyChantal Grandjean0Chantal Grandjean1Marie-Hélène Perez2Marie-Hélène Perez3Anne-Sylvie Ramelet4Anne-Sylvie Ramelet5The OCToPuS ConsortiumAnne-Laure LauriaAngelo PolitoNathalie BochatonDaniel TrachselMark MarstonSilvia SchnidrigTilman HumplBjarte RogdoEllen WildThomas NeuhausSandra StalderBarbara BrotschiFranziska von ArxAnna-Barbara SchlüerThomas RiedelPascale Van KleefPediatric Intensive and Intermediate Care Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, SwitzerlandInstitute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, SwitzerlandPediatric Intensive and Intermediate Care Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, SwitzerlandFaculty of Biology and Medicine, University of Lausanne, Lausanne, SwitzerlandPediatric Intensive and Intermediate Care Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, SwitzerlandInstitute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, SwitzerlandIntroductionChronic critically ill patients (CCI) in pediatric intensive care unit (PICU) are at risk of negative health outcomes, and account for a considerable amount of ICU resources. This study aimed to (a) describe the prevalence of CCI children, (b) compare their clinical characteristics and ICU resources use with non-CCI children, and (c) identify associated risk factors of CCI.MethodsA retrospective national registry study including 2015–2017 data from the eight Swiss PICUs of five tertiary and three regional hospitals, admitting a broad case-mix of medical and surgical patients, including pre- and full-term infants. CCI patients were identified using an adapted definition: PICU length of stay (LOS) ≥8 days and dependence on ≥1 PICU technology.ResultsOut of the 12,375 PICU admissions, 982 (8%) were CCI children and compared to non-CCI children, they were younger (2.8 vs. 6.7 months), had more cardiac conditions (24% vs. 12%), and higher mortality rate (7% vs. 2%) (p < 0.001). Nursing workload was higher in the CCI compared to the non-CCI group (22 [17–27]; 21 [16–26] respectively p < 0.001). Factors associated with CCI were cardiac (aOR = 2.241) and neurological diagnosis (aOR = 2.062), surgery (aORs between 1.662 and 2.391), ventilation support (aOR = 2.278), high mortality risk (aOR = 1.074) and agitation (aOR = 1.867).Conclusionthe results confirm the clinical vulnerability and the complexity of care of CCI children as they were defined in our study. Early identification and adequate staffing is required to provide appropriate and good quality care.https://www.frontiersin.org/articles/10.3389/fped.2023.1194833/fullhealth resourceschronic diseasechronic critical illness (CCI)critical careintensive care unitspediatrics |
| spellingShingle | Chantal Grandjean Chantal Grandjean Marie-Hélène Perez Marie-Hélène Perez Anne-Sylvie Ramelet Anne-Sylvie Ramelet The OCToPuS Consortium Anne-Laure Lauria Angelo Polito Nathalie Bochaton Daniel Trachsel Mark Marston Silvia Schnidrig Tilman Humpl Bjarte Rogdo Ellen Wild Thomas Neuhaus Sandra Stalder Barbara Brotschi Franziska von Arx Anna-Barbara Schlüer Thomas Riedel Pascale Van Kleef Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study Frontiers in Pediatrics health resources chronic disease chronic critical illness (CCI) critical care intensive care units pediatrics |
| title | Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study |
| title_full | Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study |
| title_fullStr | Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study |
| title_full_unstemmed | Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study |
| title_short | Comparison of clinical characteristics and healthcare resource use of pediatric chronic and non-chronic critically ill patients in intensive care units: a retrospective national registry study |
| title_sort | comparison of clinical characteristics and healthcare resource use of pediatric chronic and non chronic critically ill patients in intensive care units a retrospective national registry study |
| topic | health resources chronic disease chronic critical illness (CCI) critical care intensive care units pediatrics |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1194833/full |
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