TY - JOUR
T1 - The impact of strict public health restrictions on pediatric critical illness
AU - Maddux, Aline B.
AU - Campbell, Kristen
AU - Woodruff, Alan G.
AU - LaVelle, Jaime
AU - Lutmer, Jeffrey
AU - Kennedy, Curt E.
AU - Malakooti, Marcelo
AU - McGuire, John K.
AU - Shekerdemian, Lara
AU - Leah Harris, Z.
AU - McCrory, Michael C.
AU - Carpenter, Todd C.
N1 - Funding Information:
National Institute of Child Health and Human Development (K23HD096018) and institutional funds from the University of Colorado’s Section of Pediatric Critical Care Medicine; she received support for article research from the NIH. The remaining authors have disclosed that they do not have any potential conflicts of interest.
Funding Information:
11 Department of Pediatrics, The University of Texas at Austin and Dell Children’s Medical Center, Austin, TX. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal). Dr. Maddux’s institution received funding from the National Institutes of Health (NIH) and the Eunice Kennedy Shriver
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021
Y1 - 2021
N2 - OBJECTIVES: To characterize the impact of public health interventions on the volume and characteristics of admissions to the PICU. DESIGN: Multicenter retrospective cohort study. SETTING: Six U.S. referral PICUs during February 15, 2020 May 14, 2020, compared with the same months during 2017 2019 (baseline). PATIENTS: PICU admissions excluding admissions for illnesses due to severe acute respiratory syndrome coronavirus 2 and readmissions during the same hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcome was admission volumes during the period of stay-At-home orders (March 15, 2020 May 14, 2020) compared with baseline. Secondary outcomes were hospitalization characteristics including advanced support (e.g., invasive mechanical ventilation), PICU and hospital lengths of stay, and mortality. We used generalized linear mixed modeling to compare patient and admission characteristics during the stay-At-home orders period to baseline. We evaluated 7,960 admissions including 1,327 during March 15, 2020 May 14, 2020. Daily admissions and patients days were lower during the period of stay-At-home orders compared with baseline: median admissions 21 (interquartile range, 17 25) versus 36 (interquartile range, 30 42) (p < 0.001) and median patient days 93.0 (interquartile range, 55.9 136.7) versus 143.6 (interquartile range, 108.5 189.2) (p < 0.001). Admissions during the period of stay-At-home orders were less common in young children and for respiratory and infectious illnesses and more common for poisonings, endocrinopathies and for children with race/ethnicity categorized as other/unspecified. There were no differences in hospitalization characteristics except fewer patients received noninvasive ventilation during the period of stay-At-home orders. CONCLUSIONS: Reductions in PICU admissions suggest that much of pediatric critical illness in younger children and for respiratory and infectious illnesses may be preventable through targeted public health strategies.
AB - OBJECTIVES: To characterize the impact of public health interventions on the volume and characteristics of admissions to the PICU. DESIGN: Multicenter retrospective cohort study. SETTING: Six U.S. referral PICUs during February 15, 2020 May 14, 2020, compared with the same months during 2017 2019 (baseline). PATIENTS: PICU admissions excluding admissions for illnesses due to severe acute respiratory syndrome coronavirus 2 and readmissions during the same hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcome was admission volumes during the period of stay-At-home orders (March 15, 2020 May 14, 2020) compared with baseline. Secondary outcomes were hospitalization characteristics including advanced support (e.g., invasive mechanical ventilation), PICU and hospital lengths of stay, and mortality. We used generalized linear mixed modeling to compare patient and admission characteristics during the stay-At-home orders period to baseline. We evaluated 7,960 admissions including 1,327 during March 15, 2020 May 14, 2020. Daily admissions and patients days were lower during the period of stay-At-home orders compared with baseline: median admissions 21 (interquartile range, 17 25) versus 36 (interquartile range, 30 42) (p < 0.001) and median patient days 93.0 (interquartile range, 55.9 136.7) versus 143.6 (interquartile range, 108.5 189.2) (p < 0.001). Admissions during the period of stay-At-home orders were less common in young children and for respiratory and infectious illnesses and more common for poisonings, endocrinopathies and for children with race/ethnicity categorized as other/unspecified. There were no differences in hospitalization characteristics except fewer patients received noninvasive ventilation during the period of stay-At-home orders. CONCLUSIONS: Reductions in PICU admissions suggest that much of pediatric critical illness in younger children and for respiratory and infectious illnesses may be preventable through targeted public health strategies.
KW - Epidemiology
KW - Intensive care units
KW - Patient admission
KW - Pediatric
KW - Primary prevention
KW - Respiratory tract infections
KW - Severe acute respiratory syndrome coronavirus 2
UR - http://www.scopus.com/inward/record.url?scp=85122047442&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85122047442&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000005200
DO - 10.1097/CCM.0000000000005200
M3 - Article
C2 - 34259665
AN - SCOPUS:85122047442
SN - 0090-3493
VL - 49
SP - 2033
EP - 2041
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 12
ER -
