María Del P Arias López1, Ariel L Fernández2, Karina Fiquepron3, Claudia Meregalli4, María E Ratto5, Alejandro Siaba Serrate6. 1. PICU, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina. 2. SATI-Q Program, Sociedad Argentina de Terapia Intensiva, Buenos Aires, Argentina. 3. PICU, Hospital El Cruce Dr. Néstor Carlos Kirchner, Alta Complejidad en Red, Buenos Aires, Argentina. 4. PICU, Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina. 5. PICU, Hospital de Niños Sor María Ludovica, Buenos Aires, Argentina. 6. PICU, Hospital Universitario Austral, Buenos Aires, Argentina.
Abstract
OBJECTIVES: To determine the prevalence of children with complex chronic conditions in PICUs in Argentina. To describe the demographic profile, clinical course and outcomes in PICU of children with complex chronic condition in comparison to previously healthy children. DESIGN: Prospective, observational multicenter study. SETTING: Nineteen PICUs located in Argentina belonging to public and private institutions. PATIENTS: All children admitted to the participating PICUs between March 1, 2015, and February 28, 2016. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: We analyzed 3,483 PICU admissions. The prevalence of complex chronic condition was 48.06% (95% CI, 46.39-49.72). Cardiovascular complex chronic condition was predominant (22.24% [421/1,893]), followed by neuromuscular complex chronic condition (18.75% [355/1,893]) and malignant disease 17.7% (335/1,893). Technologic dependence was present in 22.22% of the patients (372 of 1,674). Predominant admission diagnosis was postoperative (36.6%) and respiratory disease (28.32%). Children with complex chronic condition had higher mortality than previously healthy patients (odds ratio, 2.74; 95% CI, 2.01-3.73). The risk of prolonged stay (≥ 26 d) was also higher (odds ratio, 1.44; 95% CI, 1.10-1.89). Rate utilization of the following devices was higher in patients with complex chronic condition: mechanical ventilation (odds ratio, 1.35; 95% CI, 1.12-1.63), central venous catheter (odds ratio, 1.24; 95% CI, 1.04-1.48), and arterial monitoring (odds ratio, 1.33; 95% CI, 1.09-1.63). CONCLUSIONS: We observed a high prevalence of patients with complex chronic condition in this sample of argentine PICUs. These patients presented higher mortality and resource use than previously healthy children. This information is valuable to understand the impact that patients with complex chronic condition have on PICU performance and enables proper planning of care.
OBJECTIVES: To determine the prevalence of children with complex chronic conditions in PICUs in Argentina. To describe the demographic profile, clinical course and outcomes in PICU of children with complex chronic condition in comparison to previously healthy children. DESIGN: Prospective, observational multicenter study. SETTING: Nineteen PICUs located in Argentina belonging to public and private institutions. PATIENTS: All children admitted to the participating PICUs between March 1, 2015, and February 28, 2016. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: We analyzed 3,483 PICU admissions. The prevalence of complex chronic condition was 48.06% (95% CI, 46.39-49.72). Cardiovascular complex chronic condition was predominant (22.24% [421/1,893]), followed by neuromuscular complex chronic condition (18.75% [355/1,893]) and malignant disease 17.7% (335/1,893). Technologic dependence was present in 22.22% of the patients (372 of 1,674). Predominant admission diagnosis was postoperative (36.6%) and respiratory disease (28.32%). Children with complex chronic condition had higher mortality than previously healthy patients (odds ratio, 2.74; 95% CI, 2.01-3.73). The risk of prolonged stay (≥ 26 d) was also higher (odds ratio, 1.44; 95% CI, 1.10-1.89). Rate utilization of the following devices was higher in patients with complex chronic condition: mechanical ventilation (odds ratio, 1.35; 95% CI, 1.12-1.63), central venous catheter (odds ratio, 1.24; 95% CI, 1.04-1.48), and arterial monitoring (odds ratio, 1.33; 95% CI, 1.09-1.63). CONCLUSIONS: We observed a high prevalence of patients with complex chronic condition in this sample of argentine PICUs. These patients presented higher mortality and resource use than previously healthy children. This information is valuable to understand the impact that patients with complex chronic condition have on PICU performance and enables proper planning of care.
Authors: Larissa Karoline Dias da Silva Casemiro; Luís Carlos Lopes-Júnior; Fabrine Aguilar Jardim; Mariane Caetano Sulino; Regina Aparecida Garcia de Lima Journal: PLoS One Date: 2022-06-10 Impact factor: 3.752
Authors: Mohamad-Hani A Temsah; Ayman A Al-Eyadhy; Fahad M Al-Sohime; Marwah M Hassounah; Mohammed A Almazyad; Gamal M Hasan; Amr A Jamal; Ali A Alhaboob; Majed A Alabdulhafid; Noura A Abouammoh; Khalid A Alhasan; Abdullah A Alwohaibi; Yousef T Al Mana; Abdullah T Alturki Journal: Saudi Med J Date: 2020-11 Impact factor: 1.484
Authors: José Colleti; Arnaldo Prata-Barbosa; Fernanda Lima-Setta; Orlei Ribeiro de Araujo; Nelson K Horigoshi; Regina Grigolli Cesar; Andreia Aparecida Freitas Souza; Flávia Andrea Krepel Foronda; Carlos Gustavo de Almeida; Lara de Araujo Torreão; Francielly Crestani; Ana Paula de Carvalho Panzeri Carlotti; Pedro Celiny Ramos Garcia Journal: J Pediatr (Rio J) Date: 2021-12-31 Impact factor: 2.990