PATIENT CHARACTERISTICS AND RESOURCE UTIL IZATION IN 9 FRENCH PEDIATRIC INTENSIVE-CARE UNITS

Evaluation of case-mix and resource consumption in pediatric intensive care units (ICU) is required. Aims. - This study describes the patter ns of pediatric ICU resource consumption, determines the impact of pri mary clinical characteristics (particularly severity of illness) on re source utilization, and analyses medical efficiency with the frequency of inappropriate stays in French pediatric ICU. Methods, - Prospectiv e study in nine French volunteer multidisciplinary pediatric ICUs from December 1993 to April 1994. Premature neonates were excluded. Resour ce consumption was expressed using the Omega system and length of stay , from which total Omega per admission, and average daily Omega (total Omega/length of stay) were obtained. Results, - Seven hundred and twe lve patients were eligible. Twenty-five percent were full-term neonate s, 30% infants (I month to I year), and 45% children. Surgical patient s constituted 22% of the population. A chronic disease tr;as present i n 45% of infants and children. Immunodeficiency was present in 10% of patients. The median length of stay was 4 days (range: 1-155). The mea n Omega scores per admission were: total Omega = 92 +/- 124, Omega/day = 14 +/- 9. Sixty-four percent required mechanical ventilation and 37 % during more than 2 days. Forty-two percent had a central venous acce ss, and 23% an arterial line. The resource consumption was greater in non-survivors, surgical patients, neonates, and immunosuppressed patie nts. The mean PRISM score was 9 +/- 9. Mortality was 13%. The Omega/da y and the PRISM score correlated. The frequency of inappropriate slays was 7.6% and accounted for 1.0% of the overall Omega activity. Conclu sions. - The results of this study can be used for interinstitutional comparison and a broader appraisal of pediatric intensive care. They i llustrate the relationship between severity of illness and resource co nsumption. French pediatric ICU efficiency seems to be high, as compar ed to North American and Dutch results.