Lampin Marie E, Duhamel Alain, Béhal Hélène, Leteurtre Stephane, Leclerc Francis, Recher Morgan
Pediatric Critical Care Unit, University Hospital of Lille, Lille, F-59000, France.
University of Lille, University Hospital of Lille, ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, Lille, F-59000, France.
Indian J Pediatr. 2025 Feb;92(2):150-156. doi: 10.1007/s12098-023-04902-4. Epub 2023 Nov 16.
To describe the characteristics of patients admitted to Pediatric Intermediate Care Units (PImCU) and to assess their illness severity trajectories.
This prospective, observational, multicentre cohort study was conducted in seven French PImCUs between September 2012 and January 2014. All consecutive patients aged under 18 were included. The severity of illness was evaluated through the Paediatric Advanced Warning Score (PAWS), measured every 8 h for each patient. A latent class mixed model was used to identify severity trajectory classes.
A total of 2868 patients were included. The median [interquartile range] age was 29 [5-103] mo and the median length of stay was 1 [1-3] d. The primary indication for admission was respiratory (44%). Almost 3% of the patients were subsequently transferred to a pediatric intensive care unit. Three severity trajectory classes were identified. In one class, comprising the largest proportion of patients, the PAWS was low on admission and did not change markedly over time. In this class, patients were older and had a shorter length of stay. The other two classes were characterized by a higher PAWS on admission and rapid or slow improvement. These patients were more severely ill, mostly due to respiratory failure.
A large proportion of patients had a stable profile and no signs of severity which suggests that the stay in PImCU was not indicated but a part of these patients have remained stable perhaps because of the advanced monitoring and intensive nursing in these units.
The study was registered with ClinicalTrials.gov Protocol, Identifier: NCT02304341, ClinicalTrials.gov .
描述入住儿科中级护理病房（PImCU）患者的特征，并评估其疾病严重程度轨迹。
这项前瞻性、观察性、多中心队列研究于2012年9月至2014年1月在法国的7个PImCU进行。纳入所有年龄在18岁以下的连续患者。通过儿科高级预警评分（PAWS）评估疾病严重程度，每位患者每8小时测量一次。使用潜在类别混合模型识别严重程度轨迹类别。
共纳入2868例患者。年龄中位数[四分位间距]为29[5 - 103]个月，住院时间中位数为1[1 - 3]天。入院的主要指征是呼吸系统疾病（44%）。近3%的患者随后被转入儿科重症监护病房。识别出三种严重程度轨迹类别。在一类中，患者比例最大，入院时PAWS较低，且随时间变化无明显改变。在这类中，患者年龄较大，住院时间较短。另外两类的特征是入院时PAWS较高，且改善迅速或缓慢。这些患者病情更严重，主要原因是呼吸衰竭。
很大一部分患者病情稳定且无严重程度迹象，这表明入住PImCU并无必要，但其中一部分患者可能由于这些病房的先进监测和强化护理而保持稳定。
该研究已在ClinicalTrials.gov注册，协议标识符：NCT02304341，ClinicalTrials.gov 。
