European Child & Adolescent Psychiatry

, Volume 19, Issue 4, pp 389–393

Prolonged stay at the paediatric intensive care unit associated with paediatric delirium

  • Inge A. P. Smeets
  • Eva Y. L. Tan
  • Helen G. M. Vossen
  • Piet L. J. M. Leroy
  • Richel H. B. Lousberg
  • Jim van Os
  • Jan N. M. Schieveld
Original Contribution

Abstract

The objective of this study was to investigate, under circumstances of routine care, the impact of paediatric delirium (PD) on length of stay in the paediatric intensive care unit (PICU) as well as on direct financial costs. A five-year prospective observational study (2002–2007) was carried out in a tertiary eight-bed PICU in the Netherlands. Critically ill children aged 1 to 18 years who were acutely, non-electively and consecutively admitted to the PICU and detected as having PD in routine care were compared to critically ill children aged 1 to 18 years without signs of PD. PD, population characteristics and severity of illness at admission were used as predictors for length of PICU stay. Differences in length of stay yielded short-term, direct medical costs associated with PD. Forty-nine children with and 98 children without PD were included. PD prolonged length of PICU stay with 2.39 days, independent of severity of illness, age, gender, mechanical ventilation and medical indication for admission (B = 0.38, P < 0.001). PD increased direct medical costs with 1.5%. The results suggest a negative prognostic influence of PD on duration of PICU stay in routine care, resulting in an increase of direct medical costs.

Keywords

Delirium Children Paediatric intensive care unit Length of stay Costs 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Inge A. P. Smeets
    • 1
  • Eva Y. L. Tan
    • 1
  • Helen G. M. Vossen
    • 1
  • Piet L. J. M. Leroy
    • 2
  • Richel H. B. Lousberg
    • 1
  • Jim van Os
    • 1
    • 3
  • Jan N. M. Schieveld
    • 4
  1. 1.Department of Psychiatry and Psychology, European Graduate School of NeuroscienceMaastricht University Medical Centre+MaastrichtThe Netherlands
  2. 2.Department of Paediatrics, Division of Paediatric Intensive CareMaastricht University Medical Centre+MaastrichtThe Netherlands
  3. 3.Division of Psychological MedicineInstitute of PsychiatryLondonUK
  4. 4.Division of Child and Adolescent Psychiatry, Department of Psychiatry and PsychologyMaastricht University Medical Centre+MaastrichtThe Netherlands

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