Deprivation, ethnicity and prematurity in infant respiratory failure in PICU in the UK.
OBJECTIVE
To describe the epidemiology of infants admitted to Paediatric Intensive Care (PIC) with acute respiratory failure including bronchiolitis.


METHODS
Data from all consecutive admissions from 2004 to 2007 in all 29 designated Paediatric Intensive Care Units (PICUs) in England and Wales were collected. Admission rates, risk-adjusted mortality, length of stay, ventilation status, preterm birth, deprivation and ethnicity were studied.


RESULTS
A total of 4641 infants under 1 year of age had an unplanned admission to PIC with acute respiratory failure (ARF), an admission rate of 1.80 per 1000 infants per year. There was a reduced rate of admission with bronchiolitis in South Asian children admitted to PICU, which is not explained by case-mix. Children born preterm had a higher rate of admission and longer stay, but a similar low mortality. Risk-adjusted mortality was higher in South Asian infants and the highest in those with ARF (OR 1.76, 95% CI 1.20-2.57) compared with the rest of the PICU population.


CONCLUSIONS
Acute respiratory failure in infants causes most of the seasonal variation in unplanned admission to intensive care. Socioeconomic deprivation and prematurity are additional risk factors for admission. Fewer South Asian infants are admitted to PICU with a diagnosis of bronchiolitis, but risk-adjusted mortality is higher in South Asian infants overall.
O'Donnell
D R
DR
Cambridge University Clinical School, Department of Paediatrics, Addenbrooke's Hospital, Cambridge, UK. drod@addenbrookes.nhs.uk
Parslow
R C
RC
Draper
E S
ES
D044466:Asian People / Q000208:ethnology / Q000706:statistics & numerical data; D001988:Bronchiolitis / Q000208:ethnology*; D004739:England / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000208:ethnology*; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000208:ethnology*; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors; D014852:Wales / Q000453:epidemiology