Scope and impact of early and late preterm infants admitted to the PICU with respiratory illness

Abstract

Objective: To determine the clinical course and outcomes of children born early preterm (EPT, <32 weeks), late preterm (LPT, 32 to 35 weeks), and full term (FT, >or=36 weeks) who were subsequently admitted to the pediatric intensive care unit (PICU) with respiratory illness.

Study design: Retrospective chart review of patients <2 years old admitted to a tertiary PICU with respiratory illness.

Results: Two hundred seventy-one patients met inclusion criteria: 17.3% were EPT, 12.2% were LPT, and 70.5% were FT. Lower respiratory tract infection was the most common diagnosis (55%) for all groups. Median PICU length of stay was longer for EPT (6.3 days) and LPT infants (7.1 days) compared with FT infants (3.7 days; P < .03 for both comparisons). EPT and LPT infants had longer hospital stays (median, 11.7 and 13.8 days, respectively) compared with FT infants (median, 7.1 days; P < .03 and P = .004, respectively). Median hospital charges were also greater for EPT ($85 151) and LPT ($83 576) groups compared with FT group ($55 122; P < .01 and P < .02, respectively).

Conclusions: EPT and LPT infants comprise a considerable proportion of PICU admissions for respiratory illness and have greater resource utilization than FT infants.

Figure 1

Preterm infants had longer lengths of stay in the PICU and the hospital compared with full term infants. Length of stay in both the PICU and the hospital are displayed by gestational age at birth. Solid circles represent total hospital days, and open circles represent PICU days. Straight bars represent median values. Significant differences between the groups are shown with the p-values.

Figure 2

Preterm infants incurred greater hospital charges than term infants. Hospital charges are displayed by gestational age at birth. Straight bars represent median values. Significant differences between the groups are shown with the p-values.