Deprivation, ethnicity and prematurity in infant respiratory failure in PICU in the UK

• Published in: Acta Paediatrica 2010-08, Vol.99 (8), p.1186-1191
• Main Authors: O'Donnell, DR, Parslow, RC, Draper, ES
• Format: Article
• Language: English
• Subjects: Asian Continental Ancestry Group - ethnology; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Bronchiolitis; Bronchiolitis - ethnology; Chronic obstructive pulmonary disease, asthma; Deprivation; England - epidemiology; Epidemiology; Ethnicity; Female; General aspects; Health Status Disparities; Hospitalization - statistics & numerical data; Humans; Infant; Infant Mortality - ethnology; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - ethnology; Intensive Care Units, Pediatric; Length of Stay - statistics & numerical data; Male; Medical sciences; Paediatric intensive care; Pneumology; Respiratory Distress Syndrome, Newborn - ethnology; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Seasons; Socioeconomic Factors; Wales - epidemiology
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2010.01803.x

Aim:  To describe the epidemiology of infants admitted to Paediatric Intensive Care (PIC) with acute respiratory failure including bronchiolitis. Methods:  Data from all consecutive admissions from 2004 to 2007 in all 29 designated Paediatric Intensive Care Units (PICUs) in England and Wales were collected. Admission rates, risk‐adjusted mortality, length of stay, ventilation status, preterm birth, deprivation and ethnicity were studied. Results:  A total of 4641 infants under 1 year of age had an unplanned admission to PIC with acute respiratory failure (ARF), an admission rate of 1.80 per 1000 infants per year. There was a reduced rate of admission with bronchiolitis in South Asian children admitted to PICU, which is not explained by case‐mix. Children born preterm had a higher rate of admission and longer stay, but a similar low mortality. Risk‐adjusted mortality was higher in South Asian infants and the highest in those with ARF (OR 1.76, 95% CI 1.20–2.57) compared with the rest of the PICU population. Conclusion:  Acute respiratory failure in infants causes most of the seasonal variation in unplanned admission to intensive care. Socioeconomic deprivation and prematurity are additional risk factors for admission. Fewer South Asian infants are admitted to PICU with a diagnosis of bronchiolitis, but risk‐adjusted mortality is higher in South Asian infants overall.