Characteristics and outcomes of adolescents requiring admission to the intensive care unit: A retrospective cohort study

Abstract

Background: Critically ill adolescents are not a well-studied patient population. The optimal setting (pediatric or adult intensive care unit [ICU]) for caring for them is not clear. This study assessed adolescents admitted to the adult ICU and compared the characteristics and outcomes of younger versus older patients. Methods: This was a retrospective study of adolescent patients aged 14–19 years who were admitted to an adult tertiary care ICU between January 1, 2015, and December 31, 2020. Patients were divided into two groups, younger (14–16 years old) and older adolescents (17–19 years old). Results: The study included 276 patients; 105 patients were aged 14–16 years and 171 patients 17–19 years. Most patients were males (69.9%); only nine patients had body weights < 30 kg. Trauma was the most common reason for admission (36.2% of the younger group and 49.7% of the older group, P = 0.03) with sepsis being also common (19% of the younger group and 20.5% of the older group). Vasopressor therapy was required for 39.1% of patients and invasive mechanical ventilation for 58% (no between-group difference). The hospital mortality was 16.7% (odds ratio in younger versus older group adjusted for illness severity, 0.804; 95% confidence interval, 0.358–1.802). Mechanical ventilation duration and stay in the ICU and hospital were similar in both groups. Conclusions: Trauma was the most common reason for admission of adolescents aged 14–19 years to the adult ICU. The hospital mortality of younger and older adolescents was similar, suggesting that the management of younger adolescents in the adult ICU is safe.