Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK.
Department of Health Sciences, University of Leicester, Leicester, UK.
Arch Dis Child. 2018 Apr;103(4):341-345. doi: 10.1136/archdischild-2017-313915. Epub 2017 Oct 30.
To determine the number of individual children admitted to Paediatric Intensive Care Units (PICUs) in England and Wales between 2004 and 2013 and to investigate potential factors for any change over time, including ethnicity.
Anonymised demographic and epidemiological data were extracted from the Paediatric Intensive Care Audit Network (PICANet) database and analysed for all children resident in England and Wales admitted to PICUs of National Health Service (NHS) hospitals in those countries between 2004 and 2013. Population data, including births, were obtained from the Office of National Statistics and analysed. Predicted numbers of children admitted to PICU were compared with actual admissions, averaged over 3-year periods.
Increasing numbers of individual children were admitted to PICUs in England and Wales between 2004 and 2013. The largest increases were among younger children (0-5 years) and those with primary respiratory or cardiac diagnoses. They were also greatest in regions with the most mothers born overseas. From 2009 onwards, more children were admitted to PICUs than predicted, separate from overall population growth, South Asian ethnicity or requirement for ventilation.
An additional increase in the number of children from England and Wales admitted to PICU from 2009 onwards is not explained by a rising child population or an increased risk of admission among South Asian children. There was no evidence of a reduction in the admission criteria to PICUs. Given healthcare funding in England and Wales, continued increases would present a challenging prospect for both providers and commissioners of these services.
确定 2004 年至 2013 年间在英格兰和威尔士的儿科重症监护病房（PICU）收治的个体儿童数量，并研究随时间变化的潜在因素，包括种族。
从儿科重症监护审计网络（PICANet）数据库中提取匿名人口统计学和流行病学数据，并分析 2004 年至 2013 年间居住在英格兰和威尔士的所有儿童，这些儿童被收入英国国民健康服务（NHS）医院的 PICU。人口数据，包括出生人数，来自国家统计局并进行分析。预测的 PICU 入院人数与实际入院人数进行比较，平均为 3 年。
2004 年至 2013 年间，英格兰和威尔士的 PICU 收治的个体儿童人数不断增加。增幅最大的是年龄较小的儿童（0-5 岁）和患有原发性呼吸或心脏疾病的儿童。在海外出生母亲最多的地区增幅最大。自 2009 年以来，除了总人口增长、南亚裔种族或需要通气外，PICU 收治的儿童人数超过了预测人数。
2009 年以来，来自英格兰和威尔士的 PICU 收治的儿童人数增加，这不能用儿童人口增加或南亚裔儿童入院风险增加来解释。PICU 的入院标准没有证据表明有所放宽。考虑到英格兰和威尔士的医疗保健资金，这些服务的提供者和决策者都将面临持续增加的挑战。
