• Chani Traube, Elizabeth A Mauer, Linda M Gerber, Savneet Kaur, Christine Joyce, Abigail Kerson, Charlene Carlo, Daniel Notterman, Stefan Worgall, Gabrielle Silver, and Bruce M Greenwald.
• 1Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, NY.2Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.3Weill Cornell Medical College, New York, NY.4Department of Molecular Biology, Princeton University, Princeton, NJ.5Department of Pediatrics, Weill Cornell Medical College, New York, NY.6Department of Child Psychiatry, Weill Cornell Medical College, New York, NY.
• Crit. Care Med. 2016 Dec 1; 44 (12): e1175-e1179.

ObjectiveTo determine the costs associated with delirium in critically ill children.DesignProspective observational study.SettingAn urban, academic, tertiary-care PICU in New York city.PatientsFour-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014.InterventionsNone.Measurements And Main ResultsAll children were assessed for delirium daily throughout their PICU stay. Hospital costs were analyzed using cost-to-charge ratios, in 2014 dollars. Median total PICU costs were higher in patients with delirium than in patients who were never delirious ($18,832 vs $4,803; p < 0.0001). Costs increased incrementally with number of days spent delirious (median cost of $9,173 for 1 d with delirium, $19,682 for 2-3 d with delirium, and $75,833 for > 3 d with delirium; p < 0.0001); this remained highly significant even after adjusting for PICU length of stay (p < 0.0001). After controlling for age, gender, severity of illness, and PICU length of stay, delirium was associated with an 85% increase in PICU costs (p < 0.0001).ConclusionsPediatric delirium is associated with a major increase in PICU costs. Further research directed at prevention and treatment of pediatric delirium is essential to improve outcomes in this population and could lead to substantial healthcare savings.

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