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Emergency paediatric critical care in England: describing trends using routine hospital data

OBJECTIVE: To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). DESIGN: Birth cohort study created from Hospital Episode Statistics. SETTING: National Health Service funded hospitals in Eng...

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Autores principales: Lewis, Kate Marie, Parekh, Sanjay M, Ramnarayan, Padmanabhan, Gilbert, Ruth, Hardelid, Pia, Wijlaars, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588403/
https://www.ncbi.nlm.nih.gov/pubmed/32444447
http://dx.doi.org/10.1136/archdischild-2019-317902
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author Lewis, Kate Marie
Parekh, Sanjay M
Ramnarayan, Padmanabhan
Gilbert, Ruth
Hardelid, Pia
Wijlaars, Linda
author_facet Lewis, Kate Marie
Parekh, Sanjay M
Ramnarayan, Padmanabhan
Gilbert, Ruth
Hardelid, Pia
Wijlaars, Linda
author_sort Lewis, Kate Marie
collection PubMed
description OBJECTIVE: To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). DESIGN: Birth cohort study created from Hospital Episode Statistics. SETTING: National Health Service funded hospitals in England. PATIENTS: 8 577 680 singleton children born between 1 May 2003 and 31 April 2017. OUTCOME MEASURES: 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. INTERVENTIONS: 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. RESULTS: 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). CONCLUSIONS: Between 2008/2009 and 2016/2017, an increasing proportion of admissions with indicators of high dependency care took place in hospitals without a PICU.
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spelling pubmed-75884032020-10-29 Emergency paediatric critical care in England: describing trends using routine hospital data Lewis, Kate Marie Parekh, Sanjay M Ramnarayan, Padmanabhan Gilbert, Ruth Hardelid, Pia Wijlaars, Linda Arch Dis Child Original Research OBJECTIVE: To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). DESIGN: Birth cohort study created from Hospital Episode Statistics. SETTING: National Health Service funded hospitals in England. PATIENTS: 8 577 680 singleton children born between 1 May 2003 and 31 April 2017. OUTCOME MEASURES: 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. INTERVENTIONS: 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. RESULTS: 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). CONCLUSIONS: Between 2008/2009 and 2016/2017, an increasing proportion of admissions with indicators of high dependency care took place in hospitals without a PICU. BMJ Publishing Group 2020-11 2020-05-22 /pmc/articles/PMC7588403/ /pubmed/32444447 http://dx.doi.org/10.1136/archdischild-2019-317902 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Lewis, Kate Marie
Parekh, Sanjay M
Ramnarayan, Padmanabhan
Gilbert, Ruth
Hardelid, Pia
Wijlaars, Linda
Emergency paediatric critical care in England: describing trends using routine hospital data
title Emergency paediatric critical care in England: describing trends using routine hospital data
title_full Emergency paediatric critical care in England: describing trends using routine hospital data
title_fullStr Emergency paediatric critical care in England: describing trends using routine hospital data
title_full_unstemmed Emergency paediatric critical care in England: describing trends using routine hospital data
title_short Emergency paediatric critical care in England: describing trends using routine hospital data
title_sort emergency paediatric critical care in england: describing trends using routine hospital data
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588403/
https://www.ncbi.nlm.nih.gov/pubmed/32444447
http://dx.doi.org/10.1136/archdischild-2019-317902
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