Document Detail

Mortality in very long-stay pediatric intensive care unit patients and incidence of withdrawal of treatment.
MedLine Citation:
PMID:  19855954     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The mortality for children with prolonged stay in pediatric intensive care units (PICU) is much higher than overall mortality. The incidence of withdrawal or limitation of therapy in this group is unknown. PURPOSE: To assess mortality and characteristics of children admitted for >or=28 days to our ICU, and to describe the extent to which limitations of care were involved in the terminal phase preceding death. METHODS: For the period 2003 to 2005 clinical data were collected retrospectively for children with prolonged stay (defined as >or=28 days) in a medical/surgical PICU of a university children's hospital. RESULTS: In the PICU, 4.4% of the children (116/2,607, equal gender, mean age 29 days) had a prolonged stay. Median (range) stay was 56 (28-546) days. These children accounted for 3% of total admissions and occupied 63% of total admission days. Mortality during admission for this group was five times higher (22%) than the average PICU mortality rate of 4.6%. Withdrawal or limitation of therapy preceded 70% of deaths. CONCLUSIONS: Children with prolonged stay in the PICU have a significantly high risk of mortality. Death is typically preceded by limitation of care.
Sara Naghib; Cynthia van der Starre; Saskia J Gischler; Koen F M Joosten; Dick Tibboel
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Publication Detail:
Type:  Journal Article     Date:  2009-10-24
Journal Detail:
Title:  Intensive care medicine     Volume:  36     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-6     Citation Subset:  IM    
Department of Intensive Care, Erasmus Medical Centre, Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
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MeSH Terms
Catchment Area (Health)
Child, Preschool
Critical Care / statistics & numerical data
Hospital Mortality / trends*
Infant, Newborn
Intensive Care Units, Pediatric / statistics & numerical data*
Length of Stay / statistics & numerical data
Netherlands / epidemiology
Patient Admission / statistics & numerical data
Withholding Treatment / statistics & numerical data*

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