TY - JOUR
T1 - Cost Associated with Pediatric Delirium in the ICU
AU - Traube, Chani
AU - Mauer, Elizabeth A.
AU - Gerber, Linda M.
AU - Kaur, Savneet
AU - Joyce, Christine
AU - Kerson, Abigail
AU - Carlo, Charlene
AU - Notterman, Daniel
AU - Worgall, Stefan
AU - Silver, Gabrielle
AU - Greenwald, Bruce M.
N1 - Publisher Copyright:
Copyright © 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - 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.
AB - 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.
KW - costs
KW - critical care
KW - delirium
KW - economic analysis
KW - pediatric
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U2 - 10.1097/CCM.0000000000002004
DO - 10.1097/CCM.0000000000002004
M3 - Article
C2 - 27518377
AN - SCOPUS:84981730232
SN - 0090-3493
VL - 44
SP - e1175-e1179
JO - Critical care medicine
JF - Critical care medicine
IS - 12
ER -