Long Stay and Frequent Readmission in the Pediatric Intensive Care in the Netherlands; 15-Year Time Trends

Liz van de Riet, Marieke H. Otten, Clara D. van Karnebeek, Job B. M. van Woensel, Casper W. Bollen, Jeroen R. ter Horst, Richard H. Klein, Jan Willem Kuiper, Maaike A. Riedijk, Carin W. M. Verlaat, Dick A. van Waardenburg

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OBJECTIVES: To describe time trends and the burden of long-stay patients (LSP) and frequent-readmission patients (FRP) in the PICUs in The Netherlands. DESIGN: Retrospective analysis of data from the nationwide Pediatric Intensive Care Evaluation registry including all PICU admissions in The Netherlands. SETTING: All PICUs in The Netherlands. PATIENTS: All PICU patients less than 18 years old admitted between 2003 and 2017. Two groups of patients were identified: LSP (admitted ≥30 d) and FRP (≥3 readmissions within the first year after their first admission). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 47,424 children were admitted on 59,759 occasions. LSP (3.3% of total cohort) and FRP (2.1%) accounted for 37.5% and 14.5% of cumulative admission days, respectively. Patients fulfilling both LSP and FRP criteria (0.6%) accounted for 9.9% of cumulative admission days. No significant time trends were observed between 2003 and 2017 for the number of LSP and FRP, nor for accounted cumulative admission days. Age and disease severity-adjusted mortality was significantly higher for LSP (odds ratio [OR], 2.16; 95% CI, 1.66-2.82; p < 0.001) and FRP OR 1.40 (95% CI, 0.97-2.01; p = 0.069) compared with the general PICU population. Overall PICU mortality decreased significantly between 2003 (6.5%) and 2017 (3.7%; p = 0.004), but remained constant over time for both LSP (17.2%) and FRP (6.3%). CONCLUSIONS: The proportion of LSP and FRP and their burden on PICU capacity are considerable and remained constant between 2003 and 2017. Whereas age and disease severity-adjusted mortality decreased in the general PICU population, it did not change in LSP and FRP.

Original languageEnglish
Pages (from-to)E0798
JournalCritical Care Explorations
Issue number12
Publication statusPublished - 5 Dec 2022


  • bed occupancy
  • length of stay
  • pediatric intensive care unit
  • pediatric intensive care unit mortality
  • pediatric intensive care unit readmissions

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