Cost Associated With Pediatric Delirium in the ICU

被引：129

作者：

Traube, Chani ^{[1
]}

Mauer, Elizabeth A. ^{[2
]}

Gerber, Linda M. ^{[2
]}

Kaur, Savneet ^{[1
]}

Joyce, Christine ^{[1
]}

Kerson, Abigail ^{[3
]}

Carlo, Charlene ^{[1
]}

Notterman, Daniel ^{[4
]}

Worgall, Stefan ^{[5
]}

Silver, Gabrielle ^{[6
]}

Greenwald, Bruce M. ^{[1
]}

机构：

[1] Weill Cornell Med Coll, Pediat Crit Care Med, New York, NY 10065 USA

[2] Weill Cornell Med Coll, Dept Healthcare Policy & Res, New York, NY USA

[3] Weill Cornell Med Coll, New York, NY USA

[4] Princeton Univ, Dept Mol Biol, Princeton, NJ USA

[5] Weill Cornell Med Coll, Dept Pediat, New York, NY USA

[6] Weill Cornell Med Coll, Dept Child Psychiat, New York, NY USA

来源：

CRITICAL CARE MEDICINE | 2016年 / 44卷 / 12期

关键词：

costs; critical care; delirium; economic analysis; pediatric;

D O I：

10.1097/CCM.0000000000002004

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To determine the costs associated with delirium in critically ill children. Design: Prospective observational study. Setting: An urban, academic, tertiary-care PICU in New York city. Patients: Four-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014. Interventions: None. Measurements and Main Results: All children were assessed for delirium daily throughout their PICU stay. Hospital costs were analyzed using cost- to-charge ratios, in 2014 dollars. Median total PICU costs were higher in patients with delirium than in patients who were never delirious ($18,832 vs $4,803; p < 0.0001). Costs increased incrementally with number of days spent delirious (median cost of $9,173 for 1 d with delirium, $19,682 for 2-3 d with delirium, and $75,833 for > 3 d with delirium; p < 0.0001); this remained highly significant even after adjusting for PICU length of stay (p < 0.0001). After controlling for age, gender, severity of illness, and PICU length of stay, delirium was associated with an 85% increase in PICU costs (p < 0.0001). Conclusions: Pediatric delirium is associated with a major increase in PICU costs. Further research directed at prevention and treatment of pediatric delirium is essential to improve outcomes in this population and could lead to substantial healthcare savings.

引用

页码：E1175 / E1179

页数：5

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