A population based observational study of childhood encephalitis in children admitted to pediatric intensive care units in England and Wales
A population based observational study of childhood encephalitis in children admitted to pediatric intensive care units in England and Wales
BACKGROUND: Encephalitis is a serious neurologic condition which can result in admission to intensive care. Yet, there are no studies on pediatric intensive care unit (PICU) admission rates and usage of intensive care resources by children with encephalitis in England and Wales. The objectives of this study were to (i) define the PICU incidence and mortality rates for childhood encephalitis, (ii) describe usage of intensive care resources by children with encephalitis admitted to PICU, and (iii) explore the associated cost from PICU encephalitis admissions.
METHODS: Retrospective analysis of anonymized data for 1031 children (0-17 years) with encephalitis admitted (January 2003 to December 2013) to PICU in England and Wales.
RESULTS: The PICU encephalitis incidence was 0.79/100,000 population/year (95%CI 0.74-0.84), which gives an annual total of 214 bed days of intensive care occupancy for children admitted with encephalitis and an estimated annual PICU bed cost of £414,230 (IQR 198,111-882,495) for this cohort. PICU encephalitis admissions increased during the study period (annual percentage change = 4.5%, 95%CI 2.43%-6.50%, p=<0.0001). In total, 808/1024 (78.9%) received invasive ventilation while 216/983 (22.0%) and 50/890 (5.6%) cases received vasoactive treatment and renal support, respectively. There were 87 deaths (8.4%), giving a PICU encephalitis mortality rate of 0.07 /100,000 population (0-17 years)/year (95%CI 0.05-0.08).
CONCLUSIONS: These data suggest that encephalitis places a significant burden to the healthcare service. More work is needed to improve outcomes for children with encephalitis.
673–677
Iro, Mildred A.
8a5c81c4-0746-4f19-b1fc-7889d20e02eb
Sadarangani, Manish
2319d171-d1ab-42d5-bcd0-1f4a0d1ce53f
Nickless, Alecia
e32ee3fc-cfe3-4b68-ab31-d1d5cb056594
Kelly, Dominic F.
7bbff692-ee15-4821-abe7-78c1fa8e44d8
Pollard, Andrew J.
f54083f3-c730-4ecb-937e-6fb11fdd6a21
July 2019
Iro, Mildred A.
8a5c81c4-0746-4f19-b1fc-7889d20e02eb
Sadarangani, Manish
2319d171-d1ab-42d5-bcd0-1f4a0d1ce53f
Nickless, Alecia
e32ee3fc-cfe3-4b68-ab31-d1d5cb056594
Kelly, Dominic F.
7bbff692-ee15-4821-abe7-78c1fa8e44d8
Pollard, Andrew J.
f54083f3-c730-4ecb-937e-6fb11fdd6a21
Iro, Mildred A., Sadarangani, Manish, Nickless, Alecia, Kelly, Dominic F. and Pollard, Andrew J.
(2019)
A population based observational study of childhood encephalitis in children admitted to pediatric intensive care units in England and Wales.
The Pediatric Infectious Disease Journal, 38 (7), .
(doi:10.1097/INF.0000000000002280).
Abstract
BACKGROUND: Encephalitis is a serious neurologic condition which can result in admission to intensive care. Yet, there are no studies on pediatric intensive care unit (PICU) admission rates and usage of intensive care resources by children with encephalitis in England and Wales. The objectives of this study were to (i) define the PICU incidence and mortality rates for childhood encephalitis, (ii) describe usage of intensive care resources by children with encephalitis admitted to PICU, and (iii) explore the associated cost from PICU encephalitis admissions.
METHODS: Retrospective analysis of anonymized data for 1031 children (0-17 years) with encephalitis admitted (January 2003 to December 2013) to PICU in England and Wales.
RESULTS: The PICU encephalitis incidence was 0.79/100,000 population/year (95%CI 0.74-0.84), which gives an annual total of 214 bed days of intensive care occupancy for children admitted with encephalitis and an estimated annual PICU bed cost of £414,230 (IQR 198,111-882,495) for this cohort. PICU encephalitis admissions increased during the study period (annual percentage change = 4.5%, 95%CI 2.43%-6.50%, p=<0.0001). In total, 808/1024 (78.9%) received invasive ventilation while 216/983 (22.0%) and 50/890 (5.6%) cases received vasoactive treatment and renal support, respectively. There were 87 deaths (8.4%), giving a PICU encephalitis mortality rate of 0.07 /100,000 population (0-17 years)/year (95%CI 0.05-0.08).
CONCLUSIONS: These data suggest that encephalitis places a significant burden to the healthcare service. More work is needed to improve outcomes for children with encephalitis.
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Accepted/In Press date: 31 December 2018
e-pub ahead of print date: 4 February 2019
Published date: July 2019
Identifiers
Local EPrints ID: 431018
URI: http://eprints.soton.ac.uk/id/eprint/431018
ISSN: 0891-3668
PURE UUID: 7c5d244e-3cab-4d84-857f-1e026c657bec
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Date deposited: 21 May 2019 16:30
Last modified: 16 Mar 2024 07:50
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Contributors
Author:
Manish Sadarangani
Author:
Alecia Nickless
Author:
Dominic F. Kelly
Author:
Andrew J. Pollard
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