The impact of prematurity: a perspective of pediatric intensive care units.
OBJECTIVE
To evaluate the relative resource use of pediatric intensive care unit (PICU) patients who had been born prematurely.


METHODS
Nonconcurrent cohort study.


METHODS
Consecutive admissions to 16 voluntary PICUs.


METHODS
A total of 431 formerly premature patients (FPP) and 5,319 nonpremature patients.


METHODS
None


METHODS
Patients with a history of prematurity and a prematurity-related complication or an anatomical deformity were compared for demographic and resource requirements to a group of non-premature patients by a bivariable logistic regression analysis that controlled for age as a co-morbid factor.


RESULTS
Compared with other patients, FPP were younger (34.9 +/- 2.2 months vs. 72.4 +/- 1.0 months; p < .001), readmitted to the PICU more often during the same hospitalization (11.1% vs. 5.5%; p < .001), used more chronic technologies (ventilators, gastrostomy tubes, tracheostomy tubes, and parenteral nutrition; 30.3% vs. 5.6%; p < .001), and had longer lengths of stay (5.98 +/-0.59 days vs. 3.56 +/- 0.12 days; p = .004). FPP had significantly higher use of ventilators (45.5% vs. 35.0%; p < .007) and lower use of arterial catheters (27.8% vs. 35.9%, p = .006) and central venous catheters (16.9% vs. 20.9%, p = .026) than nonprematures. The need for other PICU resources, including vasopressors, were similar.


CONCLUSIONS
FPP used more chronic and acute care resources than patients who were not prematurely born. Continued improvements in neonatal care will influence change in many aspects of the health care system. This will also affect the delivery of care to the current patient base of the PICU.
Slonim
A D
AD
Critical Care Medicine Department, Warren G. Magnuson Clinical Center, and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Washington, DC, USA.
Patel
K M
KM
Ruttimann
U E
UE
Pollack
M M
MM
D016022:Case-Control Studies; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000401:mortality / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000628:therapy; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology