Paediatric intensive care in a district general hospital.
The report of the 'National Coordinating Group on Paediatric Intensive Care' (NHS Executive 1997) recommended that general (adult) intensive care units in district general hospitals should no longer continue to care for critically ill children apart from providing resuscitation prior to transfer to a specialist centre. This recommendation was made despite a lack of outcome data in the UK to support this conclusion. We wish to report our outcome data from one such unit. Over a four-year period, we have prospectively used Paediatric Risk of Mortality scoring to estimate the risk of death for 95 children cared for in our adult unit in a district general hospital (DGH) and have compared this with the observed outcome. The observed mortality of 2 deaths was less than the predicted mortality of 2.32 deaths. Our results suggest that an adult unit can provide a paediatric intensive care service that is associated with an acceptable outcome in terms of mortality. These data suggest that the role of such units with regard to the provision of paediatric intensive care should be considered further.
Kinnear
K
K
Intensive Care Unit, Southend Hospital, Essex, UK.
Higgins
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000592:standards*; D004739:England; D005260:Female; D006302:Health Services Research; D017052:Hospital Mortality; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D018579:Patient Selection; D010372:Pediatrics / Q000592:standards*; D015397:Program Evaluation; D011446:Prospective Studies; D012307:Risk Factors