Complex chronic conditions rose among children admitted to a Swiss PICU

Researchers compared all children younger than 17 admitted to the University Children’s Hospital Zurich PICU in 2007 and 2017. The retrospective observational study included 981 children in 2007 and 886 in 2017; the analysis used Feudtner’s definition of complex chronic conditions (CCCs), with an expanded condition list. The investigators assessed CCC prevalence and categories, patient characteristics, length of stay and mortality-related measures.

The proportion of children with CCCs increased from 61% in 2007 to 70% in 2017. Cardiovascular conditions remained the most common category (55% and 52%, respectively), followed by congenital or genetic conditions (36% and 38%). Neurologic or neuromuscular conditions increased from 25% to 34%, while the share of children with at least three chronic conditions rose from 16% to 25%. PICU length of stay was longer among children with CCCs and increased with the number of conditions. Among deaths, the proportion following withdrawal of intensive care treatment increased from 8% to 48%.

The findings describe changes at one Swiss tertiary center and do not establish why they occurred or whether they apply to other PICUs. The two-cohort retrospective design and the absence of an internationally accepted CCC definition limit comparisons. The results may inform local planning for PICU care and resources, but do not evaluate interventions or patient outcomes beyond the reported measures.