Evaluation of discharge to palliative care following critical care: a pediatric intensive care perspective
European Journal of Pediatrics, cilt.185, sa.9, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 185 Sayı: 9
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00431-026-07396-2
- Dergi Adı: European Journal of Pediatrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Length of stay, Logistic regression, Pediatric intensive care, Pediatric palliative care, Technology-dependent children, Tracheostomy
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
This study aimed to analyze the demographic and clinical characteristics of patients transferred from the pediatric intensive care unit (PICU) to the pediatric palliative care unit (PPCU), and to assess the independent impact of medical technology dependence—including mechanical ventilation, tracheostomy, and percutaneous endoscopic gastrostomy (PEG)—on PICU length of stay (LOS) and readmission frequency. This retrospective, single-center study analyzed the records of 303 patients transferred from a tertiary-level PICU to a pediatric palliative care unit between January 1, 2023, and December 31, 2025. Demographic data, diagnostic groups, PICU length of stay, mechanical ventilation (MV), tracheostomy (TK), and PEG status were analyzed. Binary logistic regression was performed to identify independent predictors of multiple PICU readmissions (≥ 2 admissions) and prolonged LOS (> 15 days). Of 4,083 PICU discharges, 303 (7.4%) transferred to PPCU; 43.2% had neurological disorders. Tracheostomy independently predicted multiple readmissions (OR = 2.06, p = 0.042) and prolonged stay (OR = 2.59, p = 0.009). Ventilation predicted prolonged stay (OR = 7.47, p = 0.013), whereas PEG predicted shorter stay (OR = 0.37, p < 0.001). Female gender predicted higher readmissions (p = 0.003). Conclusion: Technology dependence—particularly tracheostomy and mechanical ventilation—is a key independent determinant of prolonged PICU occupancy and recurrent hospitalizations among children requiring palliative care. These findings underscore the need to optimize the integration of palliative care within intensive care workflows and to establish comprehensive, multidisciplinary post-discharge follow-up protocols. (Table presented.)