Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018
Abstract 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) ar...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-023-04254-0 |
| _version_ | 1797451472125820928 |
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| author | Tim J. van Hasselt Hari Krishnan Kanthimathinathan Trishul Kothari Adrian Plunkett Chris Gale Elizabeth S. Draper Sarah E. Seaton |
| author_facet | Tim J. van Hasselt Hari Krishnan Kanthimathinathan Trishul Kothari Adrian Plunkett Chris Gale Elizabeth S. Draper Sarah E. Seaton |
| author_sort | Tim J. van Hasselt |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-09T14:55:09Z |
| format | Article |
| id | doaj.art-571022dd117a4cecb2b7f07a6d9daca0 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-03-09T14:55:09Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-571022dd117a4cecb2b7f07a6d9daca02023-11-26T14:15:28ZengBMCBMC Pediatrics1471-24312023-08-0123111210.1186/s12887-023-04254-0Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018Tim J. van Hasselt0Hari Krishnan Kanthimathinathan1Trishul Kothari2Adrian Plunkett3Chris Gale4Elizabeth S. Draper5Sarah E. Seaton6Department of Population Health Sciences, University of LeicesterPaediatric Intensive Care Unit, Birmingham Women’s and Children’s NHS Foundation TrustBirmingham Women’s and Children’s NHS Foundation TrustPaediatric Intensive Care Unit, Birmingham Women’s and Children’s NHS Foundation TrustSchool of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College LondonDepartment of Population Health Sciences, University of LeicesterDepartment of Population Health Sciences, University of LeicesterAbstract 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.https://doi.org/10.1186/s12887-023-04254-0Pediatric intensive care unitsPrematurityNeonatalNeonatal intensive careChronic disease |
| spellingShingle | Tim J. van Hasselt Hari Krishnan Kanthimathinathan Trishul Kothari Adrian Plunkett Chris Gale Elizabeth S. Draper Sarah E. Seaton Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 BMC Pediatrics Pediatric intensive care units Prematurity Neonatal Neonatal intensive care Chronic disease |
| title | Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 |
| title_full | Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 |
| title_fullStr | Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 |
| title_full_unstemmed | Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 |
| title_short | Impact of prematurity on long-stay paediatric intensive care unit admissions in England 2008-2018 |
| title_sort | impact of prematurity on long stay paediatric intensive care unit admissions in england 2008 2018 |
| topic | Pediatric intensive care units Prematurity Neonatal Neonatal intensive care Chronic disease |
| url | https://doi.org/10.1186/s12887-023-04254-0 |
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