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European Journal of Pediatrics

, Volume 178, Issue 2, pp 155–160 | Cite as

Long-term mortality and functional outcome after prolonged paediatric intensive care unit stay

  • Noboru Matsumoto
  • Takeshi HatachiEmail author
  • Yu Inata
  • Yoshiyuki Shimizu
  • Muneyuki Takeuchi
Original Article

Abstract

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.

Keywords

Long-term outcome Mortality Pediatric Overall Performance Category Prolonged Resource Paediatric intensive care units 

Abbreviations

IQR

Interquartile range

PICUs

Paediatric intensive care units

PIM2

Paediatric index of mortality 2

POPC score

Pediatric Overall Performance Category score

Notes

Acknowledgements

We thank the staff at our PICU for cooperating with us on this study. We would also like to thank Kenji Hirai (health information manager).

Authors’ contributions

NM contributed to the conception and design of the study, the acquisition and analysis of the data, the drafting of the manuscript, and the critical revision of the manuscript for important intellectual content.

TH contributed to the conception and design of the study, the acquisition and analysis of the data, and the drafting of the manuscript, and played a large role in the writing of the manuscript.

YI contributed to the conception and design of the study, the interpretation of the data, and the revision of the manuscript.

YS contributed to the conception and design of the study, the interpretation of the data, and the revision of the manuscript.

MT contributed to the conception and design of the study, the interpretation of the data, and the revision of the manuscript.

All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent was not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Intensive Care MedicineOsaka Women’s and Children’s HospitalOsakaJapan

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