title: Adults with childhood-onset chronic conditions admitted to US pediatric and adult intensive care units.
abstract: OBJECTIVE
  The purpose of the study is to compare demographics, intensive care unit (ICU) admission characteristics, and ICU outcomes among adults with childhood-onset chronic conditions (COCCs) admitted to US pediatric and adult ICUs.
  
  
  METHODS
  Retrospective cross-sectional analyses of 6088 adults aged 19 to 40 years admitted in 2008 to 70 pediatric ICUs that participated in the Virtual Pediatric Intensive Care Unit Performance Systems and 50 adult ICUs that participated in Project IMPACT.
  
  
  RESULTS
  Childhood-onset chronic conditions were present in 53% of young adults admitted to pediatric units, compared with 9% of those in adult units. The most common COCC in both groups were congenital cardiac abnormalities, cerebral palsy, and chromosomal abnormalities. Adults with COCC admitted to pediatric units were significantly more likely to be younger, have lower functional status, and be nontrauma patients than those in adult units. The median ICU length of stay was 2 days, and the intensive care unit mortality rate was 5% for all COCC patients with no statistical difference between pediatric or adult units.
  
  
  CONCLUSIONS
  There are marked differences in characteristics between young adults with COCC admitted to pediatric ICUs and adult ICUs. Barriers to accommodating these young adults may be reasons why many such adults have not transitioned from pediatric to adult critical care.
authors.affiliation: Division of Pediatric Critical Care Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY. Electronic address: jde2134@columbia.edu.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Edwards
authors.affiliation: Division of General Internal Medicine and Public Health, Vanderbilt University School of Medicine, Nashville, TN; Geriatric Research, Education and Clinical Center (GRECC) Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN; Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Eduard E
authors.initials: EE
authors.lastname: Vasilevskis
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Drexel University College of Medicine, Philadelphia, PA.
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Yoo
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Houtrow
authors.affiliation: Department of Epidemiology & Biostatistics, University of California, San Francisco, CA; Department of Medicine, University of California, San Francisco, CA.
authors.forename: W John
authors.initials: WJ
authors.lastname: Boscardin
authors.affiliation: Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, CA; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA.
authors.forename: R Adams
authors.initials: RA
authors.lastname: Dudley
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA; Division of General Pediatrics, Department of Pediatrics, University of California, San Francisco, CA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA.
authors.forename: Megumi J
authors.initials: MJ
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002908:Chronic Disease / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003422:Critical Care; D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D060305:Transition to Adult Care; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic disease; Critical care; Intensive care units; Young adult