title: Children who 'grow up' in hospital: Inpatient stays of six months or longer.
abstract: OBJECTIVE
  To describe the clinical course of all infants and children hospitalized for six consecutive months (180 days) or longer at a tertiary/quaternary children's hospital in Western Canada.
  
  
  METHODS
  A retrospective review of medical records for all eligible patients from January 1, 2007 to December 31, 2012 at Stollery Children's Hospital (Edmonton, Alberta) was performed.
  
  
  RESULTS
  A total of 61 patients experienced 64 eligible hospitalizations. The mean length of stay was 326 days, corresponding to a cumulative 20,892 hospital days (57.2 patient-years). Prevalent procedures resulting in long hospitalization were long-term tracheostomy ± ventilation in 32 (52%) patients, need for organ transplantation in 24 (39%) with completed transplantation in 15 (25%), and ventricular-assist devices (VADs) in seven (11%). Sixteen (26%) patients in the study group died, and 16 (26%) were placed in long-term care or out-of-home care at the end of their long hospitalization. Of children displaced from their family home, 14 (88%) were Aboriginal.
  
  
  CONCLUSIONS
  Infants and children who experience very long hospitalizations have complex illnesses, with substantial risk for mortality and a high rate of displacement from their families after discharge. Aboriginal children appear to be particularly vulnerable to displacement and problem solving for this population must be undertaken, involving a variety of stakeholders.
authors.affiliation: John Dossetor Health Ethics Centre, University of Alberta; ; Department of Pediatrics, University of Alberta;
authors.forename: Dawn
authors.initials: D
authors.lastname: Davies
authors.affiliation: Department of Pediatrics, University of Alberta; ; Integrated Quality Management Edmonton Zone, Alberta Health Services;
authors.forename: Dawn
authors.initials: D
authors.lastname: Hartfield
authors.affiliation: Stollery Children's Hospital, Edmonton, Alberta.
authors.forename: Tara
authors.initials: T
authors.lastname: Wren
keywords: Chronic illness/condition; Decision making; Family impact; Hospitalization; Infant