Ingreso prolongado en la unidad de cuidados intensivos pediátricos: mortalidad y consumo de recursos asistenciales

Abstract

Variables de interés:Se analizaron la morbimortalidad y el consumo de recursos por los pacientes con ingreso prolongado. Resultados: La mortalidad de los pacientes con ingreso prolongado fue mayor (22,9%) que la del resto de los pacientes (2%) (p < 0,001). En un 52,6% de estos pacientes el fallecimiento se produjo tras la limitación del esfuerzo terapéutico o por no iniciar medidas de reanimación. Los pacientes con ingreso prolongado presentaron una elevada incidencia de infección nosocomial (96,3%) y un elevado consumo de los recursos asistenciales (el 97,6% precisó ventilación mecá-nica; el 90,2%, transfusión de hemoderivados; el 86,7% fármacos vasoactivos intravenosos, y el 22,9%, oxigenación por membrana extracorpórea (ECMO). Conclusiones: Los niños en estado crítico con ingreso prolongado en la UCIP tienen una elevada morbimortalidad y requieren un elevado consumo de recursos asistenciales. Son necesarias medidas específicas que permitan identificar precozmente a los pacientes susceptibles de presentar ingreso prolongado para adecuar las medidas terapéuticas y los recursos disponibles y mejorar la eficiencia del tratamiento.

Hospital costs associated with nosocomial infections in a pediatric intensive care unit

“…Another factor included in our model as a risk factor is cardiovascular surgery, which could be due to the high number of patients undergoing such surgery in the PICU, postoperative LOS, frequent infectious complications and prolonged use of medical procedures, which means an increase of total economic costs. The inclusion of this factor is supported by a recent report published by González et al 35 , which states that prolonged admissions convey a greater use of medical resources, higher risk of NI and higher mortality rates among children admitted to PICU 35 . Other studies mention hospital stay 1,14 and non survival in the Unit 7,9,24 as factors capable of rising costs.…”

Influence of supplemental parenteral nutrition approach on nosocomial infection in pediatric intensive care unit of Emergency Department: a retrospective study

“…Serum albumin at admission, mechanical ventilation and severity of disease showed significant association with nosocomial infection, and these risk factors have been demonstrated by other studies [ 26 – 29 ]. PICU length of stay was also found as one predictor on nosocomial infection [ 30 ]. Although our results were similar to the previous studies, we still need to be cautious about interpreting our results, because previous studies did not take into account of timing factor or took different definition for the timing factor.…”

Predictors and Direct Cost Estimation of Long Stays in Pediatric Intensive Care Units in Saudi Arabia: A Mixed Methods Study

“…LSPs have poorer prognoses and consume healthcare resources in excess of their numeric proportion compared to short-stay patients. 5 , 26 The current study demonstrates that unit leaders believe that available hospital resources should be reserved for short-stay patients, while LSPs should be transferred to palliative care centers. LSPs in PICUs could be addressed to make more critical care beds available during medical emergencies.…”

“… 3 Furthermore, these patients occupy the already limited number of ICU beds. 5 Different approaches have been attempted to improve resource utilization in PICUs; however, they have been challenged by the unavoidable presence of LSPs. 1 There are inconsistencies in the published data regarding pediatric LSP prevalence, with limited data regarding some regions with rapidly evolving pediatric critical care services.…”