Evidence map›Paper›PMID 29946855›Full record

ArticleEuropean journal of pediatrics2018

The occurrence of adverse events in low-risk non-survivors in pediatric intensive care patients: an exploratory study.

Carin W Verlaat, Cynthia van der Starre, Jan A Hazelzet, Dick Tibboel, Johannes van der Hoeven, Joris Lemson, Marieke Zegers

Abstract read
In one paragraph

Article in European journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carin W VerlaatDepartment of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, The Netherlands. carin.verlaat@radboudumc.nl.ORCID http://orcid.org/0000-0001-9023-9725
Cynthia van der StarreDepartment of Neonatal and Pediatric Intensive Care, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Jan A HazelzetDepartment of Public Health, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Dick TibboelDepartment of Pediatric Intensive Care, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Johannes van der HoevenDepartment of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, The Netherlands.
Joris LemsonDepartment of Intensive Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, The Netherlands.
Marieke ZegersDepartment of Intensive Care and IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We studied the occurrence of adverse events (AEs) in low-risk non-survivors (LNs), compared to low-risk survivors (LSs), high-risk non-survivors (HNs), and high-risk survivors (HSs) in two pediatric intensive care units (PICUs). The study was performed as a retrospective patient record review study, using a PICU-trigger tool. A random sample of 48 PICU patients (0-18 years) was chosen, stratified into four subgroups of 12 patients: LNs, LSs, HNs, and HSs. Primary outcome was the occurrence of AEs. The severity, preventability, and nature of the indentified AEs were determined. In total, 45 AEs were found in 20 patients. The occurrence of AEs in the LN group was significantly higher compared to that in the LS group and HN group (AE occurrence: LN 10/12 patients, LS 1/12 patients; HN 2/12 patients; HS 7/12 patients; LN-LS difference, p < 0.001; LN-HN difference, p < 0.01). The AE rate in the LN group was significantly higher compared to that in the LS and HN groups (median [IQR]: LN 0.12 [0.07-0.29], LS 0 [0-0], HN 0 [0-0], and HS 0.03 [0.0-0.17] AE/PICU day; LN-LS difference, p < 0.001; LN-HN difference, p < 0.01). The distribution of the AEs among the four groups was as follows: 25 AEs (LN), 2 AEs (LS), 8 AEs (HN), and 10 AEs (HS). Fifteen of forty-five AEs were preventable. In 2/12 LN patients, death occurred after a preventable AE.

conclusionThe occurrence of AEs in LNs was higher compared to that in LSs and HNs. Some AEs were severe and preventable and contributed to mortality. What is Known: • 59-76% of all PICU patients encounter at least one adverse event during their PICU stay. • It is unknown if adverse events play a role in death of low-risk PICU patients. What is New: • In low-risk PICU non-survivors, occurrence of adverse events is higher compared to low-risk PICU survivors and to high-risk PICU non-survivors. • Severe and preventable adverse events occur in low-risk PICU non-survivors, some contributing to mortality.

Indexed as

AdolescentChildChild, PreschoolFemaleHospital MortalityHumansInfantIntensive Care Units, PediatricMaleMedical ErrorsPatient SafetyRetrospective StudiesRisk FactorsSurvivorsAdverse eventsComplicationsHealth care qualityHospitalOutcomePatient safety(P ediatric) intensive careTrigger tool

Identifiers

PMID29946855
PMCPMC6096770

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.