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  1. R Mark Beattie, Editor in Chief

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Is it taking longer to die in paediatric intensive care

Childhood mortality is falling with the majority of child deaths being in children with chronic health problems. Data from the UK Paediatric Intensive Care Audit Network (PICANet) show that crude mortality in British paediatric intensive care units (PICUs) has followed the national trend and fallen consistently from 5.5% in 2003/2004 to 3.7% in 2013. While survival is improving, the prevalence of life-limiting illness and chronic disease in British children is increasing. This is during a period of considerable growth in the provision (and availability) of paediatric intensive care. Plunkett et al explore some of the factors that may influence length of stay (165, 473 admissions, 10 years). Length of stay increased by 0.31 days/year (CI 0.169 to 0.449) in non survivors and by 0.064 (95% confidence interval 0.046 to 0.083) in survivors. Proportion of early deaths (within 24 hours of admission) fell by 0.44% points per year but the proportion of late deaths (>28 days) increased by 0.44%. This overall increase in length of stay is driven by a reduction in early deaths and increased proportion of late deaths. The authors conclude that this data suggests that the scenario of an early death in paediatric intensive care unit (PICU) following treatment failure may be being replaced by the death of a child at the end of a long PICU admission. This …

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