Long-Term Survival of Children Discharged From Pediatric Intensive Care: A Linked Data Cohort Study
Year: 2025
Type: article
Study design: Observational Study
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.
Source: Pediatric Critical Care Medicine
Institutions: The University of Queensland, Children's Health Queensland Hospital and Health Service, Monash University, Australian and New Zealand Intensive Care Society, Princess Margaret Hospital for Children, Perth Children's Hospital, The University of Sydney, Children's Hospital at Westmead, Sydney Children's Hospital, Sydney Children’s Hospitals Network, Queensland University of Technology, Royal Children's Hospital, The University of Melbourne, Murdoch Children's Research Institute
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4411091127