Alshaikh Reem, AlKhalifah Ahmed, Fayed Amel, AlYousef Sawsan
General Pediatric Department, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
Pediatric Intensive Care Unit, Qatif Central Hospital, Qatif, Saudi Arabia.
Front Pediatr. 2022 Dec 19;10:1093160. doi: 10.3389/fped.2022.1093160. eCollection 2022.
This study aimed to assess the variables contributing to the length of stay in the pediatric intensive care unit. This study utilized a retrospective design by analyzing data from the Virtual Pediatric Systems web-based database. The study was conducted in a tertiary hospital-King Fahad Medical City in Riyadh, Saudi Arabia-from January 1, 2014 to December 31, 2019. The patients were admitted to intensive care with complex medical and surgical diseases. The variables were divided into quantitative and qualitative parameters, including patient data, Pediatric Risk of Mortality III score, and complications. Data from 3,396 admissions were analyzed. In this cohort, the median and mean length of stay were 2.8 (interquartile range, 1.08-7.04) and 7.43 (standard deviation, 14.34) days, respectively. The majority of long-stay patients-defined as those staying longer than 30 days-were less than 12 months of age (44.79%), had lower growth parameters ( < 0.001), and had a history of admission to pediatric intensive care units. Moreover, the majority of long-stay patients primarily suffered from respiratory diseases (51.53%) and had comorbidities and complications during their stay ( < 0.001). Multivariate analysis of all variables revealed that central line-associated bloodstream infections ( < 0.001), external ventricular drain insertion ( < 0.005), tracheostomy ( < 0.001), and use of mechanical ventilation ( < 0.001) had the most significant associations with a longer stay in the pediatric intensive care unit. The factors associated with longer stays included the admission source, central nervous system disease comorbidity, and procedures performed during the stay. Factors such as respiratory support were also associated with prolonged intensive care unit stays.
本研究旨在评估影响儿科重症监护病房住院时间的相关变量。本研究采用回顾性设计,通过分析虚拟儿科系统基于网络的数据库中的数据展开。该研究于2014年1月1日至2019年12月31日在沙特阿拉伯利雅得的一家三级医院——法赫德国王医疗城进行。患者因复杂的内科和外科疾病入住重症监护病房。变量分为定量和定性参数,包括患者数据、儿科死亡风险Ⅲ评分及并发症。对3396例入院病例的数据进行了分析。在该队列中,住院时间的中位数和均值分别为2.8天(四分位间距为1.08 - 7.04天)和7.43天(标准差为14.34天)。大多数住院时间较长的患者(定义为住院时间超过30天的患者)年龄小于12个月(44.79%),生长参数较低(<0.001),且有入住儿科重症监护病房的病史。此外,大多数住院时间较长的患者主要患有呼吸系统疾病(51.53%),且住院期间伴有合并症和并发症(<0.001)。对所有变量进行多因素分析显示,中心静脉导管相关血流感染(<0.001)、外置脑室引流管置入(<0.005)、气管切开术(<0.001)及机械通气的使用(<0.001)与儿科重症监护病房住院时间延长的关联最为显著。与住院时间延长相关的因素包括入院来源、中枢神经系统疾病合并症以及住院期间所进行的操作。诸如呼吸支持等因素也与重症监护病房住院时间延长有关。