Emergency paediatric critical care in England: describing trends using routine hospital data.
Age Factors
Child, Preschool
Critical Care
/ statistics & numerical data
Critical Illness
/ epidemiology
Emergency Medical Services
/ statistics & numerical data
England
/ epidemiology
Female
Hospitals
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Intensive Care Units
/ statistics & numerical data
Intensive Care Units, Pediatric
/ statistics & numerical data
Logistic Models
Male
epidemiology
intensive care
Journal
Archives of disease in childhood
ISSN: 1468-2044
Titre abrégé: Arch Dis Child
Pays: England
ID NLM: 0372434
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
11
07
2019
revised:
10
03
2020
accepted:
10
04
2020
pubmed:
24
5
2020
medline:
17
12
2020
entrez:
24
5
2020
Statut:
ppublish
Résumé
To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). Birth cohort study created from Hospital Episode Statistics. National Health Service funded hospitals in England. 8 577 680 singleton children born between 1 May 2003 and 31 April 2017. Using procedure and diagnostic codes, we assigned indicators of high dependency care (eg, non-invasive ventilation) or intensive care (eg, invasive ventilation) to emergency admissions. Children were followed up until their fifth birthday to estimate high dependency and intensive care admission rates in hospitals with and without a PICU. We tested the yearly trend of high dependency and intensive care admissions to hospitals without a PICU using logistic regression models. Emergency admissions requiring high dependency care in hospitals without a PICU increased from 3.30 (95% CI 3.09 to 3.51) per 10 000 child-years in 2008/2009 to 7.58 (95% CI 7.28 to 7.89) in 2016/2017 and overtook hospitals with a PICU in 2015/2016. The odds of an admission requiring high dependency care to a hospital without a PICU compared with a hospital with a PICU increased by 9% per study year (OR 1.09, 95% CI 1.08 to 1.10). The same trend was not present for admissions requiring intensive care (OR 1.01, 95% CI 0.99 to 1.03). Between 2008/2009 and 2016/2017, an increasing proportion of admissions with indicators of high dependency care took place in hospitals without a PICU.
Identifiants
pubmed: 32444447
pii: archdischild-2019-317902
doi: 10.1136/archdischild-2019-317902
pmc: PMC7588403
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1061-1067Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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