Kroon, L. de (Lysan) (2013) Gevolgen van- en risicofactoren voor PICU heropname binnen 48 uur. thesis, Medicine.
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Abstract
Critically ill adults who are readmitted to the Intensive Care Unit (ICU) experienced longer Length Of Stay (LOS), higher mortality and higher resource consumption. We investigated whether these effects occur in critically ill children as well after Pediatric Intensive Care Unit (PICU) admission. We hypothesized that children who were readmitted had higher mortality rates and significant longer length of stay, compared to the control group. The aim of this study was to investigate the outcomes of PICU readmission, characteristics of the readmission group and to identify risk factors for readmission. Materials and Methods: This study was a retrospective cohort analysis, conducted in a 20-bed medical surgical Pediatric Intensive Care Unit. All patients who were admitted between 2006 and 2012 were included in the study. A database was made, in which patients were labeled ‘readmission in less than 48 hours’ and ‘control group’. After this, we performed two types of analyses. First we compared one part of the readmission group with the control group, using chi-square test and Mann-Whitney U test. An α level of 0.05 or lower was used as the threshold to define statistical significance. After that, we studied the characteristics of the readmission group. Results were displayed as percentages, means with standard deviations and percentages deviating from normal. Results: 4839 patients were admitted to the PICU of Beatrix Children’s hospital between 2006 and 2012. Of these children, 4.5% was readmitted. Nearly half of these children (43.3%) were readmitted in less than 48 hours after discharge. Children who were primarily admitted for a non-surgical reason, appeared to be readmitted more often (p = 0.03, odds ratio 1.7, 95% confidence interval 1.1-2.6). Patients who were readmitted were less often mechanical ventilated than children in the control group (control group: 60.5% vent., 39.5% no vent. vs readmission group: 45.7% vent., 54.3% no vent. p = <0,001, odds ratio 0.6, confidence interval 0.4-0.8). In addition, we found that a respiratory admission indication was more often reason for readmission compared to the primary admission (respectively 23% vs 32%, p = 0.05). Patients who were readmitted in less than 48 hours after PICU discharge did not show longer LOS or higher mortality. Conclusion: This study showed that the percentage of patients that were readmitted to the PICU was not high. A potential risk factor for readmission was admission for a non-surgical reason. In addition, patients who were not mechanically ventilated appeared to be readmitted more often than patients who were ventilated. Readmission was not associated with higher mortality or longer LOS.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Kneyber, dr. M.C.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:00 |
| Last Modified: | 25 Jun 2020 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2002 |
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