Department of Psychiatry and Psychology, European Graduate School of Neuroscience, Maastricht University Medical Centre+, P.O. Box 616 (DOT 10), 6200 MD, Maastricht, The Netherlands.
Eur Child Adolesc Psychiatry. 2010 Apr;19(4):389-93. doi: 10.1007/s00787-009-0063-2. Epub 2009 Sep 27.
The objective of this study was to investigate, under circumstances of routine care, the impact of paediatric delirium (PD) on length of stay in the paediatric intensive care unit (PICU) as well as on direct financial costs. A five-year prospective observational study (2002-2007) was carried out in a tertiary eight-bed PICU in the Netherlands. Critically ill children aged 1 to 18 years who were acutely, non-electively and consecutively admitted to the PICU and detected as having PD in routine care were compared to critically ill children aged 1 to 18 years without signs of PD. PD, population characteristics and severity of illness at admission were used as predictors for length of PICU stay. Differences in length of stay yielded short-term, direct medical costs associated with PD. Forty-nine children with and 98 children without PD were included. PD prolonged length of PICU stay with 2.39 days, independent of severity of illness, age, gender, mechanical ventilation and medical indication for admission (B = 0.38, P < 0.001). PD increased direct medical costs with 1.5%. The results suggest a negative prognostic influence of PD on duration of PICU stay in routine care, resulting in an increase of direct medical costs.
本研究旨在探讨在常规治疗情况下，儿科谵妄（PD）对儿科重症监护病房（PICU）住院时间以及直接医疗费用的影响。这是一项在荷兰一家三级 8 床 PICU 进行的为期五年的前瞻性观察研究（2002-2007 年）。在常规治疗中，将急性、非选择性、连续收治的 1 至 18 岁危重病儿童中出现 PD 的患儿与无 PD 迹象的 1 至 18 岁危重病儿童进行比较。PD、人口特征和入院时疾病严重程度被用作 PICU 住院时间的预测指标。PD 导致的住院时间差异产生了与 PD 相关的短期直接医疗费用。共纳入 49 例 PD 患儿和 98 例非 PD 患儿。PD 使 PICU 住院时间延长了 2.39 天，与疾病严重程度、年龄、性别、机械通气和入院医疗指征无关（B = 0.38，P < 0.001）。PD 增加了直接医疗费用 1.5%。结果表明，PD 在常规治疗中对 PICU 住院时间具有负预后影响，导致直接医疗费用增加。
