P0306 / #590: 20 YEARS OF ADMISSION REGISTRATION AT A DUTCH PEDIATRIC INTENSIVE CARE UNIT (PICU): TIME TRENDS IN LONG DURATION ADMISSION AND READMISSIONS

Abstract

Aims & Objectives: Advances in treatment options has resulted in a growing population of children who require chronic medical support that also affects the characteristics of children admitted to the PICU. To emphasize this change in the PICU population, we described 20-year time trends in long duration admission and readmissions on a Dutch PICU. Methods: All patients aged 0-17 years admitted to the PICU Academic Medical Center, Amsterdam, The Netherlands between 1997 and 2017 were extracted from the PICE registry. Main outcome measures were: number of admissions and readmissions within the first year after discharge, length of PICU stay and cumulative admission days. Results: A total of 8,234 children (42.2% female, median age at admission 2.2 years (IQR 0.4-8.4)), were admitted on 11,195 occasions and accounted for 48,964 cumulative admission days. Between 1997 and 2012 the percentage of long stayers (i.e. admission ≥30days) increased from 1.5% to 3.0% annually, and decreased to 1.9% in 2017. Subsequently, cumulative admission days for long stayers increased between 1997 and 2012 from 26% to 45% of total cumulative admission days, and decreased to 34% in 2017. Readmission occurred overall in 1,510 patients (18.3%). Frequent flyers (i.e. ≥3readmissions; n=136, 1.7%) accounted for 5,178 cumulative admission days (10.6% of total admission days); no changes in time were observed. Conclusions: Over the last 20 years significantly more patients were admitted for ≥30 days resulting in an increased burden on the PICU. This demands a new perspective to address this growing population of chronically ill patients admitted to the PICU.