Epidemiology of long-stay patients in the pediatric intensive care unit: prevalence, characteristics, resource consumption and complications.

Abstract

BackgroundThe impact of pediatric intensive care unit (PICU) utilization and resource consumption among long-stay patients has not been characterized recently. This study aimed to describe the resource consumption and characteristics of long-stay patients in a PICU.MethodsThis was a single-center descriptive cohort study of 1309 patients admitted to a PICU in 2017. The main outcome was ICU length of stay (LOS). Patients were divided into prolonged LOS (PLS) and non-PLS groups if they had an LOS of ≥ 28 or < 28 days, respectively. Two groups were compared to characterize PLS.ResultsThirty-two (2.4%) patients had a PLS and utilized 33% of PICU bed days. Factors associated with PLS with odds ratio [95% confidence interval (CI)] were being a neonate (7.8 [2.5–25.4], p = <0.001), being an infant (2.9 [1.0–9.0], p = 0.04), admission for a respiratory ailment (7.3 [1.6–44.2], p = 0.003), cardiovascular dysfunction (24.1 [4.8–152.1], p = <0.001), post-cardiac operation (8.0 [1.7–50.1], p = 0.003), post-cardiopulmonary arrest (22.8 [1.7–211.9], p = 0.01), and transfer from another facility (4.2 [1.8–10.7], p = 0.001). PLS patients developed more nosocomial infections and disproportionately received monitoring and therapeutic resources.ConclusionsA PLS was associated with substantial PICU utilization and complication rates. Future studies should aim to alleviate both institutional and patient-related issues in the affected population harboring possible risk factors for PLS.