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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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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. |
format | Online Article Text |
id | pubmed-7588403 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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