Characteristics and outcome of long-stay patients in a paediatric intensive care unit: a case-control study.

Abstract

To identify differences in baseline characteristics and outcome between long-stay and other patients admitted to a paediatric intensive care unit with the same diagnosis. Over a period of 6 y, data of paediatric intensive care unit patients with a length of stay of 30 or more days (long-stay patients) and aged 1 to 18y were retrospectively collected. Long-stay patients were matched with the next patient who was admitted to the paediatric intensive care unit with the same diagnosis. Evaluated characteristics on admission included: age, sex, presence of chronic morbidity, functional status, Pediatric Risk of Mortality score, presence of multiple organ system failure and complications during admission. Outcome (survival and functional status) was assessed 2.5 to 8.5 y after admission. Of 19 long-stay patients identified, 15 could be matched with a control patient admitted with the same diagnosis. No significant difference in baseline characteristics was found between long-stay patients and the matched controls. The mean number of complications per long-stay patient was 2.9, compared to 1.2 per control patient (p = 0.02). Infection accounted for half of the complications. Mortality rate in long-stay patients was not higher than in the matched controls (36.8 vs 26.7%, p = 0.54). Paediatric intensive care unit stay did not change functional status in either long-stay patients or controls. Long-stay patients in the paediatric intensive care unit had more complications, but baseline characteristics, mortality and functional outcome were not different from a control group admitted with the same diagnosis.