Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, Osaka, 594-1101, Japan.
Eur J Pediatr. 2019 Feb;178(2):155-160. doi: 10.1007/s00431-018-3278-8. Epub 2018 Oct 27.
We performed a retrospective, observational study of patients who had spent > 14 days in the paediatric intensive care unit (PICU) of our hospital from 2011 to 2013. Specifically, long-term mortality, functional outcome, and PICU resource occupancy were examined. All prolonged-stay patients in our study were < 15 years of age. Favourable outcomes were defined as a Pediatric Overall Performance Category (POPC) score of 1-2, and unfavourable outcomes as a POPC score of 3-6 or death. During the study period, there were 1082 PICU admissions involving 805 patients, 111 (13.8%) of whom had one or more prolonged PICU stays. Among these patients, 100 (90%) survived to PICU discharge and 92 (83%) survived to hospital discharge. At the 3-year follow-up, the survival rate was 75% (77/102; nine patients were lost to follow-up) and the favourable outcome rate was 43% (44/102) (57% among survivors). Prolonged PICU-stay patients accounted for 50.5% of the PICU patient-days. Extremely prolonged stays (≥ 28 days) correlate with low favourable outcome rates (P = 0.03), but did not correlate with mortality rates (P = 0.16).Conclusion: Although prolonged PICU-stay patients utilized many PICU resources, most survived at least 3 years, and > 50% of the survivors had a favourable functional outcome (POPC score). What is Known: • The number of patients with prolonged paediatric intensive care unit (PICU) stays is increasing. • These patients utilize many resources and are at high risk for mortality and disabilities. What is New: • Although prolonged-stay patients accounted for 50% of PICU patient-days, their 3-year survival rate and favourable functional outcome rate (based on Pediatric Overall Performance Category scores) were relatively high. • Extremely prolonged stays (≥ 28 days) correlate with low favourable functional outcomes but not with mortality.
我们对 2011 年至 2013 年期间在我院儿科重症监护病房（PICU）住院超过 14 天的患者进行了回顾性观察研究。具体来说，研究了长期死亡率、功能预后和 PICU 资源占用情况。我们研究中的所有长期住院患者均未满 15 岁。良好的预后定义为儿科整体表现类别（POPC）评分 1-2，不良预后定义为 POPC 评分 3-6 或死亡。在研究期间，有 1082 例 PICU 收治涉及 805 例患者，其中 111 例（13.8%）有一次或多次延长 PICU 停留。在这些患者中，有 100 例（90%）存活至 PICU 出院，92 例（83%）存活至出院。在 3 年随访时，生存率为 75%（77/102；9 例失访），良好预后率为 43%（44/102）（幸存者中为 57%）。延长 PICU 停留的患者占 PICU 患者住院日的 50.5%。极长时间（≥28 天）停留与低良好预后率相关（P=0.03），但与死亡率无关（P=0.16）。结论：尽管延长 PICU 停留的患者使用了大量 PICU 资源，但大多数患者至少存活 3 年，超过 50%的幸存者有良好的功能预后（POPC 评分）。已知情况：• 患有延长儿科重症监护病房（PICU）住院时间的患者数量正在增加。• 这些患者使用了大量资源，并且死亡率和残疾率很高。新情况：• 尽管延长住院时间的患者占 PICU 患者住院日的 50%，但他们的 3 年生存率和良好的功能预后率（基于儿科整体表现类别评分）相对较高。• 极长时间（≥28 天）与低良好功能预后相关，但与死亡率无关。
