PT - JOURNAL ARTICLE AU - Hari Krishnan Kanthimathinathan AU - Adrian Plunkett AU - Barnaby R Scholefield AU - Gale A Pearson AU - Kevin P Morris TI - Trends in long-stay admissions to a UK paediatric intensive care unit AID - 10.1136/archdischild-2019-317797 DP - 2020 Jun 01 TA - Archives of Disease in Childhood PG - 558--562 VI - 105 IP - 6 4099 - http://adc.bmj.com/content/105/6/558.short 4100 - http://adc.bmj.com/content/105/6/558.full SO - Arch Dis Child2020 Jun 01; 105 AB - Objective Prolonged admission to a paediatric intensive care unit (PICU) consumes significant healthcare resource. An increase in the number of long-stay admissions and bed utilisation has been reported elsewhere in the world but not in the UK. If an increasing trend of long-stay admissions is evident, this may have significant implications for provision of paediatric intensive care in the future.Design/setting/patients We retrospectively analysed prospectively collected data from Birmingham Children’s Hospital, UK, over a 20-year period from 1998 to 2017. PICU admissions, bed-days, length of stay and mortality trends were analysed and reported over four different epochs (1998–2002, 2003–2007, 2008–2012 and 2013–2017) for long-stay admissions (PICU length of stay ≥28 days) and others. Differences in patient demographics, diagnostic categorisation and hospital utilisation were also analysed.Results In total, 24 203 admissions accounted for 131 553 bed-days over the 20-year period. 705 (2.9%) long-stay admissions accounted for 42 312 (32%) bed-days. Proportion of long-stay admissions and corresponding bed-days increased from 1.6% and 20.5% in 1998–2002 to 4.5% and 42.6%, respectively, in 2013–2017 (p<0.001). Long-stay patients had a significantly higher number of hospital admissions (median: 4 vs 2, p<0.001) per patient and overall hospital length of stay (median: 98 vs 15, p<0.001) bed-days compared with other patients. Long-stay admissions were associated with significantly higher crude mortality (23% vs 6%, p<0.001) compared with other admissions.Conclusions A significant increase in the proportion of prolonged PICU admissions with disproportionately high resource utilisation and mortality is evident over two decades.