Clinical Profile of Children Requiring Early Unplanned Admission to the PICU

Krmpotic, Kristina; Lobos, Anna-Theresa

doi:10.1542/hpeds.2012-0081

Cited by 44 publications

(47 citation statements)

References 15 publications

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“…19 We categorized primary diagnosis ICD-9-CM diagnosis codes into broader categories of ‘reason for hospital admission’ based on previously used schema and clinical judgement, including: hematology/oncology, cardiovascular, congenital anomalies, endocrine, gastrointestinal, infection, injury/poisoning, neurology, respiratory and other (Appendix 1). 20–22 We identified all additional conditions using ICD-9-CM diagnosis codes.…”

Section: Methodsmentioning

confidence: 99%

Readmission and Late Mortality After Critical Illness in Childhood*

Hartman

Saeed

Bennett

et al. 2017

Pediatric Critical Care Medicine

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Objectives Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. Design We performed a retrospective observational cohort study using administrative claims data from the years 2006–2013 obtained from the Truven Health Analytics MarketScan® Database. Subjects We included all children in the dataset admitted to a U.S. ICU ≤18 years old. Interventions The primary outcome was non-elective readmission in the year following discharge. Risk of rehospitalization was determined using a Cox proportional hazards model. Measurements and Main Results We identified 109,130 children with at least one ICU admission in the dataset. Over three-quarters of the index ICU admissions (78.6%) had an ICU length of stay ≤ 3 days and the overall index hospitalization mortality rate was 1.4%. In multivariate analysis, risk of non-elective readmission for children without cancer was higher with longer index ICU admission LOS, younger age, and several chronic and acute conditions. By the end of the one year observation period, 36.0% of children with an index ICU LOS ≥ 14 days had been readmitted, compared to only 13.9% of children who had an index ICU LOS = 1 day. Mortality in the year after ICU discharge was low overall (106 deaths per 10,000 person-years of observation), but was highest among children with an initial index ICU admission LOS ≥ 14 days (599 deaths per 10,000 person-years). Conclusions Readmission after ICU care is common. Further research is needed to investigate the potentially modifiable factors affecting likelihood of readmissions after discharge from the ICU. While late mortality was relatively uncommon overall, it was ten-fold higher in the year after ICU discharge than in the general U.S. pediatric population.

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Section: Methodsmentioning

confidence: 99%

Readmission and Late Mortality After Critical Illness in Childhood*

Hartman

Saeed

Bennett

et al. 2017

Pediatric Critical Care Medicine

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“…26,28 In Brazil, some abstracts publications were found in congress annals, but few publications in journals about the use of early warning scores to recognize pediatric clinical deterioration. [15][16]29 However, certain studies have described the profile of pediatric patients admitted to the hospital or intensive care unit, [7][8][9][10][11][12] These events are considered indicators of worsening of the hospitalized child's clinical condition. Some of the results of these studies corroborate data already described in the literature and evidenced by this research.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the studies on the profile of children who needed to be admitted to the hospital or were in the ICU, age < 2 years old, male gender and hospitalization for respiratory causes were more prevalent. [7][8][9][10][11][12] The median hospital stay was 8.8 days 10 and 3.4 days. 9 In the ICU, these times were 6.9 days 7 and 5.4 days.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12] The median hospital stay was 8.8 days 10 and 3.4 days. 9 In the ICU, these times were 6.9 days 7 and 5.4 days. 8 Acute respiratory diseases remain the most frequent cause of child mortality in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…Studies show that conditions such as age under 1 or 2 years old, male gender and respiratory diseases were more prevalent in children admitted to the ICU. [7][8][9][10][11][12] Risk factors such as respiratory history and history of previous hospitalization were associated with the need for hospitalization in children under one year old. 13 In this context, pediatric patients undergoing clinical deterioration require the health teams to be prepared to early recognize the signs of severity and to provide prompt care in order to avoid serious adverse events resulting from their clinical worsening.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated With the Clinical Deterioration Recognized by an Early Warning Pediatric Score

Miranda

Camargo

Sobrinho

et al. 2020

Texto contexto - enferm.

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Objective: To identify the factors associated with clinical deterioration recognized by a Pediatric Early Warning Score. Method: A cross-sectional study conducted in a tertiary pediatric public hospital with 271 children aged from zero to ten, hospitalized between May and October 2015. For the identification of the children with and without signs of clinical deterioration, the translated, adapted and validated version of the Brighton Pediatric Early Warning Score was applied to the Brazilian context. Logistic regression analysis and prevalence ratio (PR) were used to measure the association between the variables studied. A 95% Confidence Interval (CI) and p value were adopted as a measure of statistical significance to identify potential associated factors. Results: The factors associated with the clinical deterioration of the children studied were age ≤ 2 years old (p=0.000), hospitalization in the emergency unit (p=0.000), comorbidity (p=0.020) and clinical diagnosis of respiratory disease (p=0.000). Conclusion: Children ≤ 2 years old, with comorbidity, diagnosed with respiratory disease and hospitalized in the emergency unit showed an increased likelihood of clinical deterioration. The identification of factors associated with clinical deterioration may alert and direct the health team to children more susceptible to this phenomenon.

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