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Acta Anaesthesiol Scand · Sep 2008
Immediate and 5-year cumulative outcome after paediatric intensive care in Sweden.
- N Gullberg, H Kalzén, O Luhr, S Göthberg, O Winsö, A Markström, A-K Olsson, C Frostell, and Scandinavian Critical Care Trials Group.
- Department of Paediatric Anaesthesia and Intensive Care, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
- Acta Anaesthesiol Scand. 2008 Sep 1;52(8):1086-95.
BackgroundLittle has been reported about intensive care of children in Sweden. The aims of this study are to (I) assess the number of admissions, types of diagnoses and length-of-stay (LOS) for all Swedish children admitted to intensive care during the years 1998-2001, and compare paediatric intensive care units (PICUs) with other intensive care units (adult ICUs) (II) assess immediate (ICU) and cumulative 5-year mortality and (III) determine the actual consumption of paediatric intensive care for the defined age group in Sweden.MethodsChildren between 6 months and 16 years of age admitted to intensive care in Sweden were included in a national multicentre, ambidirectional cohort study. In PICUs, data were also collected for infants aged 1-6 months. Survival data were retrieved from the National Files of Registration, 5 years after admission.ResultsEight-thousand sixty-three admissions for a total of 6661 patients were identified, corresponding to an admission rate of 1.59/1000 children per year. Median LOS was 1 day. ICU mortality was 2.1% and cumulative 5-year mortality rate was 5.6%. Forty-four per cent of all admissions were to a PICU.ConclusionsThis study has shown that Sweden has a low immediate ICU mortality, similar in adult ICU and PICU. Patients discharged alive from an ICU had a 20-fold increased mortality risk, compared with a control cohort for the 5-year period. Less than half of the paediatric patients admitted for intensive care in Sweden were cared for in a PICU. Studies are needed to evaluate whether a centralization of paediatric intensive care in Sweden would be beneficial to the paediatric population.
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