Updating the Epidemiology of Pediatric Critical Care in the United States: 2001-2022.

Authors

Elizabeth Y Killien, Matthew R Keller, Karen E Segar, R Scott Watson, Mary E Hartman

Published in

Critical care medicine. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

To update data from 2001 to 2019 to evaluate how hospital and ICU admission patterns for children changed after the onset of the COVID-19 pandemic and to characterize regionalization of pediatric critical care over time.
Retrospective cohort study.
Healthcare Cost and Utilization Project's State Inpatient Databases from 21 U.S. states over 6 years between 2001 and 2022.
Hospitalized children of 0-17 years, excluding newborns.
None.
We used International Classification of Diseases, 9th revision (ICD-9)-clinical modification (CM) and International Classification of Diseases, 10th revision (ICD-10)-CM codes to identify diagnoses, comorbid conditions, organ failures, and mechanical ventilation, and used generalized linear Poisson regression and Cuzick's test to evaluate trends from 2001 to 2022. We used U.S. Census data to generate population-based incidence rates and age- and sex-adjusted national estimates of ICU admissions and costs. Of 2,617,308 hospital admissions, 410,646 admissions (15.7%) included a non-neonatal ICU admission. The population-based incidence of hospital admissions decreased from 2001 to 2022 while ICU admissions rose; ICU admission prevalence increased from 10.5% of hospitalizations in 2001 to 20.7% in 2022. The percentage of ICU patients admitted to the highest-level pediatric facilities rose from 41.1% in 2001 to 72.3% in 2019 before decreasing to 69.3% in 2022. Between 2019 and 2022, the percentage of ICU patients with chronic comorbidities, technology dependence, and organ failure decreased slightly, but the population-based incidence of comorbidities and technology dependence rose. ICU mortality decreased from 2.4% in 2001 to 1.6% in 2022. Nationally, there were an estimated 239,000 ICU admissions in 2019, increasing to 328,000 in 2022, with a rise in total hospital costs (in 2022 dollars) from $11.6 billion in 2019 to $14.4 billion in 2022.
The number of U.S. children admitted to ICUs continued to increase substantially in 2022, with rising prevalence of ICU care among hospitalized children, emphasizing the need for the U.S. healthcare system to increase pediatric critical care capacity.

PMID:
42573409
Bibliographic data and abstract were imported from PubMed on 10 Aug 2026.

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