Mairet-Mabboux S, Blache T, Facchin A, Koffel C, Ferraris A, Blakeley C, Piriou V, Henaine R, Lilot M.
Arch Cardiovasc Dis . 2025 Nov 5:S1875-2136(25)00800-9
doi: 10.1016/j.acvd.2025.09.006.
PMID: 41266182
ABSTRACT
Background: In November 2020, a structural reorganization was implemented at our institution in Lyon, France, merging two paediatric cardiac intensive care units into a single multidisciplinary intensive care unit. This consolidation aimed to centralize perioperative care for children and neonates with congenital heart disease, and improve care coordination.
Aim: To assess whether this intensive care unit merger was associated with changes in hospital length of stay, morbidity and deaths among paediatric cardiac patients.
Methods: This retrospective study included paediatric patients hospitalized between 01 February 2020 and 22 November 2020 (Pre-merger group), and between 23 November 2020 and 17 September 2021 (Post-merger group). Patients were grouped by cardiopathy and type of surgery. The t-test, Mann-Whitney test, χ2 and Fisher's exact tests were used.
Results: A total of 310 Pre-merger patients and 327 Post-merger patients were included in the analysis. Post-merger patients with cardiopulmonary bypass had a reduced length of stay both in the intensive care unit (Δ mean: -2 days, 95% Confidence Interval: -4 to 0; P=0.03) and out of the intensive care unit (Δ mean: -1.3 days, 95% Confidence Interval: -2.5 to 0; P=0.04), resulting in a reduced overall length of stay at the hospital (Δ mean: -3.3 days, 95% Confidence Interval: -6 to -1; P=0.008) compared with Pre-merger patients with cardiopulmonary bypass. No difference was observed in survival in the intensive care unit (95% Pre-merger vs. 95% Post-merger; P=0.89) or in the hospital (95% Pre-merger vs. 94% Post-merger; P=0.66) or in the occurrence of any adverse event.
Conclusions: The merger was associated with a reduced hospital length of stay without increased morbidity or deaths. Structural reorganization may improve efficiency while preserving clinical safety in specialized paediatric settings.
Keywords: Congenital cardiopathy; Length of stay; Merge; Morbidity-mortality; Paediatric cardiac intensive care unit.
