RT Journal Article
T1 Predictive model for the risk of paediatric intensive care utilization in children with medical complexity: a longitudinal retrospective cohort study
A1 Pérez-Ardanaz, Bibiana
A1 Gutiérrez-Rodríguez, Laura del Carmen
A1 Gómez-González, Alberto José
A1 Morales-Asencio, José Miguel
A1 Montero-García, Antonio Jesús
A1 León-Campos, Álvaro
K1 Enfermería de cuidados intensivos - Evaluación del riesgo
AB BackgroundChildren with medical complexity (CMC) are at increased risk of admission in intensive care. Despite improvements in mortality rates, there remains a burden of morbidity, long-term health care needs and hospital readmissions. Beyond clinical factors, socio-demographic determinants could impact utilization of acute services.AimTo identify risk factors that can differentiate CMC who are admitted to the paediatric intensive care unit (PICU).Study DesignA 6-year longitudinal retrospective cohort study evaluated clinical, socio-demographic and health care utilization.ResultsA total of 248 CMC were included, with a median age of 13 years (9.75–17.00). Intensive care admission rate was 47.2%. The risk of PICU admission was higher for children undergoing surgical interventions (HR = 1.58, 95% CI 1.34–1.86, p < .001) and those using medical devices (HR = 1.81, 95% CI 1.54–2.13, p < .001). Mother's higher educational level was a protective factor (HR = 0.66, 95% CI 0.55–0.79, p < .001). Multivariable analysis revealed significant associations between risk of admission and the presence of malignancy, comorbidities, home medical devices, surgical procedures and higher health care utilization. Children's age and higher maternal educational level acted as protective factors.ConclusionSocio-demographic factors should be considered in the provision of care to CMC. Individualized assessments to guide supportive interventions adapted to socio-economic factors may prevent PICU admissions.Relevance to Clinical PracticeThis study highlights the importance of integrating individualized assessments of socio-demographic risk factors, such as maternal educational level, into the clinical practice of paediatric nurses. Moreover, targeted interventions, including educational resources and community support programmes, may optimize care.
PB Wiley
YR 2024
FD 2024
LK https://hdl.handle.net/10630/36057
UL https://hdl.handle.net/10630/36057
LA spa
NO Pérez-Ardanaz B, Gutiérrez-Rodríguez L, Gómez-González AJ, Morales-Asencio JM, Montero-García A, León-Campos Á. Predictive model for the risk of paediatric intensive care utilization in children with medical complexity: A longitudinal retrospective cohort study. Nurs Crit Care. 2024; 1-9. doi:10.1111/nicc.13180
NO Funding for open access charge: Universidad de Málaga / CBUA
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 19 ene 2026