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Mortality in very long-stay pediatric intensive care unit patients and incidence of withdrawal of treatment

Sara Naghib| Cynthia van der Starre| Saskia J. Gischler| Koen F. M. Joosten| Dick Tibboel
Pediatric Original
Volume 36, Issue 1 / January , 2010

Pages 131 - 136

Abstract

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 ≥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 ≥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.

Keywords

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