Clinical features of pediatric patients with prolonged Pediatric Intensive Care Unit stay

Background: Patients with prolonged length of stay (PLOS) in Pediatric Intensive Care Units (PICU) pose clinical and economic challenges. In Mexico, data is limited. Objectives: To identify the clinical profile and main risk factors of children with prolonged PICU stays. Materials and methods: A retrospective cohort study of critically ill children was done. PLOS was defined as a stay longer than 14 days. PLOS frequency and patient mortality were described. Clinical profiles of patients with and without PLOS were compared and a logistic regression identified key predictors. Results: Among patients, 12.2% had PLOS, utilizing 47% of the total bed-days PICU occupancy. Mortality was 8.1% overall and 15.7% among PLOS cases. Children with PLOS significantly differed from those without in terms of illness severity, comorbidities, infections, nutrition strategies, need and duration of organ support, and mortality. Logistic regression identified mechanical ventilation (OR = 2.37) and renal/hepatic replacement therapy (OR = 44.68) as independent predictors of PLOS. Conclusions: Despite their small proportion, PLOS patients significantly impact PICU resources. Early identification and targeted care strategies are essential to improve outcomes and resource use.