TABLE 1

Prolonged PICU LOS in the Literature

StudyYearSettingCase DefinitionFindings/Comments
Pollack et al51987United States; single PICU>13 d7.1% of patients, used ∼50% of PICU resources; at 1 y follow-up, 58% died or with severe disability
Marcin et al82001United States; 32 PICUs>12 d (>95th percentile)LSP 2.1%–8.1% of population
Occupy 15.2%–57.8% of PICU bed days
Significantly higher mortality rate
Identified predictive features of LSP
Brown et al372003London, UK; tertiary pediatric cardiac surgical center≥14 d (>95th percentile)LSP 12% of population; mortality 3 times higher Identified preoperative, intra-operative, and postoperative features predictive of long-stay status
van der Heide et al412004Amsterdam, the Netherlands; single PICU≥ 30 dNo significant difference between baseline characteristics or mortality of LSP and matched control subjects; higher incidence of complications for LSP
Briassoulis et al382004Athens, Greece; single PICU>14 d20% of patients accounted for 55% of PICU patient days
>3 mo0.7% of patients accounted for 17% of PICU patient days
Conlon et al362009Dublin, Ireland; single PICU≥ 28 d3.1% of total patients over study period
21.2% PICU mortality, 14% postdischarge mortality
Long-term HRQOL normal for majority of survivors
Naghib et al402010Rotterdam, the Netherlands; single PICU≥28 d4.4% of patients had prolonged stay
3% of admissions account for 63% of PICU patient days
Mortality 5 times higher for LSP
Pagowska-Klimek et al392011Lodz, Poland; single PICU>14 d (>90th percentile)Cardiac surgery patients only
Identified risk factors associated with long stay
Edwards et al35201254 US PICUs>15 dChildren with CCCs at greater risk for prolonged LOS and PICU mortality
Namachivayam et al72012Melbourne, Australia; single PICU≥ 28 d1% of admissions, used 18.5% bed days
Bed occupancy of LSP 8% in 1989; increased to 21% in 2008
Unfavorable outcome (moderate to severe disability or death) in more than two-thirds of patients
Favorable outcome for 54% of survivors
Namachivayam et al62015Australia and New Zealand; all PICUs≥28 dNo improvement in outcomes for CCI patients over a 10 year period
  • HRQOL, health-related quality of life; LSP, long-stay patient.