Two Decades of Measuring Ins and Outs: 20 Years of Paediatric Intensive Care Unit Admissions and DISCHARGES At A Small, Tertiary Care Paediatric Hospital with A Large Geographic Catchment Area

• Published in: Paediatrics & Child Health
• Main Authors: Krmpotic, K, Young, M
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press (OUP) 2016
• Subjects: Pediatrics, Perinatology and Child Health; Newfoundland
• Online Access: http://dx.doi.org/10.1093/pch/21.supp5.e64a; https://academic.oup.com/pch/article-pdf/21/Supplement_5/e64a/45668235/pche64a.pdf

Abstract BACKGROUND: Over the past three decades, pediatric critical care has become recognized as its own subspecialty, with well documented benefits for critically ill children cared for by a pediatric intensivist, in the Pediatric Intensive Care Unit (PICU) of a tertiary care hospital. Previous studies describing the demographic of critically ill children have been conducted in large hospitals that provide tertiary and quaternary care, or nation-wide studies including several PICUs. OBJECTIVES: The primary objective of this study was to describe the volume and type of patients admitted to the PICU of a small, tertiary care pediatric hospital with a large geographic catchment area over a period of 20 years. DESIGN/METHODS: We audited a prospectively maintained, administrative database to determine the age, primary diagnosis, length of stay, and outcome for all children, newborn to 18 years of age, who were admitted to the PICU at the Janeway Children’s Health and Rehabilitation Centre in St. John’s, Newfoundland between January 1, 1995 and December 31, 2015. RESULTS: Data were available for 3800 admissions. Children requiring admission to PICU were a median age of 7.1 years (IQR 1.5 - 13.6 years). Medical patients accounted for 60% of admissions with most common diagnoses being respiratory insufficiency (32%), metabolic conditions (15%), neurological conditions (15%), trauma (14%), and cardiac insufficiency (6%). The remainder of admissions were for surgical patients from general surgery (50%), orthopedics (29%), and neurosurgery (21%). Median length of stay for admitted children was 2 days (IQR 1 – 5 days). Overall mortality rates were 2.8%. CONCLUSION: Despite the benefits associated with regionalization of pediatric critical care for acutely ill children, positive outcomes and low mortality rates are observed in a small, tertiary care hospital with a large catchment area that is geographically isolated from other parts of the country. We were able to identify common admission diagnoses for our patient ...