Davies Dawn, Hartfield Dawn, Wren Tara
John Dossetor Health Ethics Centre, University of Alberta; ; Department of Pediatrics, University of Alberta;
Department of Pediatrics, University of Alberta; ; Integrated Quality Management Edmonton Zone, Alberta Health Services;
Paediatr Child Health. 2014 Dec;19(10):533-6. doi: 10.1093/pch/19.10.533.
To describe the clinical course of all infants and children hospitalized for six consecutive months (180 days) or longer at a tertiary/quaternary children's hospital in Western Canada.
A retrospective review of medical records for all eligible patients from January 1, 2007 to December 31, 2012 at Stollery Children's Hospital (Edmonton, Alberta) was performed.
A total of 61 patients experienced 64 eligible hospitalizations. The mean length of stay was 326 days, corresponding to a cumulative 20,892 hospital days (57.2 patient-years). Prevalent procedures resulting in long hospitalization were long-term tracheostomy ± ventilation in 32 (52%) patients, need for organ transplantation in 24 (39%) with completed transplantation in 15 (25%), and ventricular-assist devices (VADs) in seven (11%). Sixteen (26%) patients in the study group died, and 16 (26%) were placed in long-term care or out-of-home care at the end of their long hospitalization. Of children displaced from their family home, 14 (88%) were Aboriginal.
Infants and children who experience very long hospitalizations have complex illnesses, with substantial risk for mortality and a high rate of displacement from their families after discharge. Aboriginal children appear to be particularly vulnerable to displacement and problem solving for this population must be undertaken, involving a variety of stakeholders.
描述在加拿大西部一家三级/四级儿童医院连续住院6个月（180天）及以上的所有婴幼儿和儿童的临床病程。
对2007年1月1日至2012年12月31日期间斯托里儿童医院（艾伯塔省埃德蒙顿）所有符合条件的患者的病历进行回顾性研究。
共有61例患者经历了64次符合条件的住院治疗。平均住院时间为326天，累计住院天数达20892天（57.2患者年）。导致长期住院的常见治疗手段包括：32例（52%）患者进行长期气管切开术±通气，24例（39%）患者需要器官移植，其中15例（25%）完成移植，7例（11%）使用心室辅助装置（VAD）。研究组中有16例（26%）患者死亡，16例（26%）患者在长期住院结束时被安排接受长期护理或家庭外护理。在与家人分离的儿童中，14例（88%）是原住民。
经历超长住院时间的婴幼儿和儿童患有复杂疾病，存在很高的死亡风险，出院后与家人分离的比例也很高。原住民儿童似乎特别容易与家人分离，必须针对这一人群采取解决措施，涉及多个利益相关方。
