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

Lewis, KM; Parekh, SM; Ramnarayan, P; Gilbert, R; Hardelid, P; Wijlaars, L; (2020) Emergency paediatric critical care in England: describing trends using routine hospital data. Archives of Disease in Childhood , 105 (11) pp. 1061-1067. 10.1136/archdischild-2019-317902. Green open access

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Abstract

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.

Type: Article
Title: Emergency paediatric critical care in England: describing trends using routine hospital data
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/archdischild-2019-317902
Publisher version: http://dx.doi.org/10.1136/archdischild-2019-317902
Language: English
Additional information: © Author(s) (or their employer[s]) 2020. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).
Keywords: epidemiology, intensive care
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10098538
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