. 2025 Aug 1;26(8):e975-e986.

doi: 10.1097/PCC.0000000000003760. Epub 2025 Jun 6.

Long-Term Survival of Children Discharged From Pediatric Intensive Care: A Linked Data Cohort Study

Anthony Slater^{1

2

3}, Shaila Chavan⁴, Elizabeth Croston⁵, Chong Tien Goh^{6

7}, Debbie Long^{1

8

9}, Johnny Millar^{10

11

12}, Breanna Pellegrini⁴, Lahn Straney², Belinda Gabbe²; Australian and New Zealand Intensive Care Society Paediatric Study Group and the Australia and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation

Collaborators, Affiliations

Collaborators

Australian and New Zealand Intensive Care Society Paediatric Study Group and the Australia and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation:
Tatjana Kerig¹³, Jennifer Darvas¹⁴, Marino Festa¹⁴, Shane George¹⁵, Corrine Balit¹⁶, Felix Oberender¹⁷, Simon Erickson¹⁸, Jenipher Chumbes Flores¹⁸, Karina Charles¹⁹, Sainath Raman¹⁹, Michaela Waak¹⁹, Debbie Long²⁰, Warwick Butt²¹, Carmel Delzoppo²¹, Ben Gelbart²¹, Kate Masterson²¹, Johnny Millar²¹, Anusha Ganeshalingam²², Claire Sherring²², Puneet Singh²³, Vicky Smith²³, Kristen S Gibbons²⁴, Kristen S Luregn J Schlapbach²⁴, Jessica Schults²⁵, David Pilcher²⁶, Jason McClure²⁶, Paul Secombe²⁷, Craig Carr²⁸, Johnny Millar²¹, Ed Litton²⁹, Shaila Chavan³⁰, Jennifer Hogan³⁰

Affiliations

¹ Department of Paediatric Intensive Care Medicine, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
³ Children's Health Queensland Clinical Unit, Medical School, The University of Queensland, South Brisbane, QLD, Australia.
⁴ Centre for Outcomes and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, VIC, Australia.
⁵ Paediatric Critical Care Unit, Perth Children's Hospital, Perth, WA, Australia.
⁶ Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Sydney, NSW, Australia.
⁷ Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
⁸ School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.
⁹ Centre for Children's Health Research, The University of Queensland, Brisbane, QLD, Australia.
¹⁰ Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
¹¹ Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.
¹² Murdoch Children's Research Institute, Melbourne, VIC, Australia.
¹³ Australian and New Zealand Paediatric Intensive Care Registry.
¹⁴ The Children's Hospital at Westmead, Sydney, NSW, Australia.
¹⁵ Gold Coast University Hospital, Gold Coast, QLD, Australia.
¹⁶ John Hunter Hospital, Newcastle, NSW, Australia.
¹⁷ Monash Children's Hospital, Melbourne, VIC, Australia.
¹⁸ Perth Children's Hospital, Perth, WA, Australia.
¹⁹ Queensland Children's Hospital, Brisbane, QLD, Australia.
²⁰ Queensland University of Technology, Brisbane, QLD, Australia.
²¹ Royal Children's Hospital, Melbourne, VIC, Australia.
²² Starship Children's Hospital, Auckland, New Zealand.
²³ Sydney Children's Hospital, Randwick, NSW, Australia.
²⁴ (The University of Queensland, Brisbane, QLD, Australia.
²⁵ The University of Queensland, Brisbane, QLD, Australia.
²⁶ Alfred Hospital, Melbourne, VIC, Australia.
²⁷ Alice Springs Hospital, Alice Springs, NT, Australia.
²⁸ Dunedin Public Hospital, Dunedin, New Zealand.
²⁹ Fiona Stanley Hospital, Perth, WA, Australia.
³⁰ Australian New Zealand Intensive Care Society, Melbourne, VIC, Australia.

PMID: 40476842
DOI: 10.1097/PCC.0000000000003760

Long-Term Survival of Children Discharged From Pediatric Intensive Care: A Linked Data Cohort Study

Anthony Slater et al. Pediatr Crit Care Med. 2025.

. 2025 Aug 1;26(8):e975-e986.

doi: 10.1097/PCC.0000000000003760. Epub 2025 Jun 6.

Authors

Collaborators

Australian and New Zealand Intensive Care Society Paediatric Study Group and the Australia and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation:
Tatjana Kerig¹³, Jennifer Darvas¹⁴, Marino Festa¹⁴, Shane George¹⁵, Corrine Balit¹⁶, Felix Oberender¹⁷, Simon Erickson¹⁸, Jenipher Chumbes Flores¹⁸, Karina Charles¹⁹, Sainath Raman¹⁹, Michaela Waak¹⁹, Debbie Long²⁰, Warwick Butt²¹, Carmel Delzoppo²¹, Ben Gelbart²¹, Kate Masterson²¹, Johnny Millar²¹, Anusha Ganeshalingam²², Claire Sherring²², Puneet Singh²³, Vicky Smith²³, Kristen S Gibbons²⁴, Kristen S Luregn J Schlapbach²⁴, Jessica Schults²⁵, David Pilcher²⁶, Jason McClure²⁶, Paul Secombe²⁷, Craig Carr²⁸, Johnny Millar²¹, Ed Litton²⁹, Shaila Chavan³⁰, Jennifer Hogan³⁰

Affiliations

¹ Department of Paediatric Intensive Care Medicine, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
³ Children's Health Queensland Clinical Unit, Medical School, The University of Queensland, South Brisbane, QLD, Australia.
⁴ Centre for Outcomes and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, VIC, Australia.
⁵ Paediatric Critical Care Unit, Perth Children's Hospital, Perth, WA, Australia.
⁶ Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Sydney, NSW, Australia.
⁷ Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
⁸ School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.
⁹ Centre for Children's Health Research, The University of Queensland, Brisbane, QLD, Australia.
¹⁰ Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
¹¹ Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.
¹² Murdoch Children's Research Institute, Melbourne, VIC, Australia.
¹³ Australian and New Zealand Paediatric Intensive Care Registry.
¹⁴ The Children's Hospital at Westmead, Sydney, NSW, Australia.
¹⁵ Gold Coast University Hospital, Gold Coast, QLD, Australia.
¹⁶ John Hunter Hospital, Newcastle, NSW, Australia.
¹⁷ Monash Children's Hospital, Melbourne, VIC, Australia.
¹⁸ Perth Children's Hospital, Perth, WA, Australia.
¹⁹ Queensland Children's Hospital, Brisbane, QLD, Australia.
²⁰ Queensland University of Technology, Brisbane, QLD, Australia.
²¹ Royal Children's Hospital, Melbourne, VIC, Australia.
²² Starship Children's Hospital, Auckland, New Zealand.
²³ Sydney Children's Hospital, Randwick, NSW, Australia.
²⁴ (The University of Queensland, Brisbane, QLD, Australia.
²⁵ The University of Queensland, Brisbane, QLD, Australia.
²⁶ Alfred Hospital, Melbourne, VIC, Australia.
²⁷ Alice Springs Hospital, Alice Springs, NT, Australia.
²⁸ Dunedin Public Hospital, Dunedin, New Zealand.
²⁹ Fiona Stanley Hospital, Perth, WA, Australia.
³⁰ Australian New Zealand Intensive Care Society, Melbourne, VIC, Australia.

PMID: 40476842
DOI: 10.1097/PCC.0000000000003760

Abstract

Objectives: The long-term survival of children discharged from PICUs and factors associated with mortality following discharge have not been systematically studied. The objective was to describe the long-term survival of children discharged alive from Australian PICUs and identify factors associated with death after discharge.

Design: A cohort data linkage study.

Setting: The Australian and New Zealand Paediatric Intensive Care Registry linked with the Australian National Death Index.

Patients: Children discharged from PICUs in Australia between 1997 and 2018.

Interventions: None.

Measurements and main results: Exposures included the time period of admission, demographic, social, and admission factors. A multivariable Cox proportional hazards model and Kaplan-Meier survival curves were used to investigate exposures associated with mortality. The records of 96,743 children were available for analysis. The risk of death reduced over time: compared with children admitted from 1997 to 2002, the hazard ratios for death after discharge for children admitted from 2003-2008, 2009-2013, to 2014-2018 were 0.92 (95% CI, 0.85-0.99), 0.69 (0.64-0.745), and 0.60 (0.55-0.65). The risk of death associated with low-risk underlying conditions, such as asthma, was 70% lower than the reference (standard risk) group, while there was a seven-fold increase in the risk of death with very-high-risk underlying conditions, such as malignancy. Residing in outer regional and very remote areas was associated with higher risk of death.

Conclusions: The survival of children discharged from Australian PICUs has improved over time; the risk of death reduced by 40% over the study period. The underlying disease, age, and residing in locations with reduced access to healthcare were associated with reduced probability of survival after discharge.

Keywords: Kaplan-Meier estimate; intensive care units; mortality; pediatric; proportional hazards models; registries; social determinants of health.

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Conflict of interest statement

The Australian and New Zealand Intensive Care Society received funding from the Ministry of Health (New Zealand), and the Australian Health Ministers’ Advisory Council. Dr. Goh received funding from the Australia and New Zealand Intensive Care Society. Dr. Gabbe’s institution received funding from the National Health and Medical Research Council of Australia (L2, ID2009998) during the preparation of this article. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

1. Australian and New Zealand Intensive Care Society: ANZICS Centre for Outcome and Resource Evaluation 2020 Report. 2021. Available at: https://www.anzics.org/wp-content/uploads/2021/09/2020-ANZICS-CORE-Repor... . Accessed September 28, 2022
1. Paediatric Intensive Care Audit Network: Annual Report 2021. Universities of Leeds and Leicester. 2022. Available at: https://www.picanet.org.uk/wp-content/uploads/sites/25/2022/04/PICANet-2... . Accessed September 27, 2022
1. Intensive Care National Audit and Research Centre: Key Statistics From the Case Mix Programme—Adult, General Critical Care Units. Case Mix Programme Summary Statistics 2019-20. 2022. Available at: https://www.icnarc.org/wp-content/uploads/2024/05/Case-Mix-Programme-Sum... . Accessed May 20, 2025
1. Chow S, Creighton P, Chambers G, et al: Report of the Australian and New Zealand Neonatal Network 2020. 2022. Available at: https://anznn.net/Portals/0/AnnualReports/Report%20of%20the%20Australian... . Accessed September 27, 2022
1. Longford N, Modi N: Analysis of Neonatal Mortality Data for the Year 2016. 2018. https://spiral.imperial.ac.uk/server/api/core/bitstreams/743965f9-8458-4... . Accessed September 27, 2022

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Long-Term Survival of Children Discharged From Pediatric Intensive Care: A Linked Data Cohort Study

Collaborators

Affiliations

Long-Term Survival of Children Discharged From Pediatric Intensive Care: A Linked Data Cohort Study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources