Research Activities, September 2013
Adults with childhood-onset illnesses are a small, but high-risk group of users of pediatric intensive care units
Some patients with childhood-onset illnesses such as congenital heart disease, cystic fibrosis, and sickle cell disease continue to receive inpatient care from pediatrics hospitals well into adulthood. A new study of 70 pediatric intensive care units (PICUs) found that 2.7 percent of admissions (1,954) in 2008 were patients 19 years or older. There was a wide variation (from 0 to 9 percent) in the proportion of adult patients across PICUs. These adult PICU patients had a greater severity of illness and preadmission disability, longer stays, and higher mortality compared with adolescent patients.
After age 18, close to 80 percent of PICU patients had a complex chronic condition, compared with 53 percent of adolescents. One in five adult PICU patients 21 years or older had congenital heart abnormalities and/or had cardiac procedures or operations. The researchers believe that as the number of adults with childhood-onset chronic illnesses grows, PICUs will need to prepare for increasingly older patients and adult ICUs will increasingly need to care for these adults. This study was partially funded by AHRQ (HS17716).
See "Multi-institutional profile of adults admitted to pediatric intensive care units," by Jeffrey D. Edwards, M.D., Amy J. Houtrow, M.D., Eduard E. Vasilevskis, M.D., and others in the May 2013 JAMA Pediatrics 167(5), pp. 436-443.