Evidence map›Paper›PMID 31072669›Full record

ArticleSurgery2019

Failure to rescue as a center-level metric in pediatric trauma.

Lucy W Ma, Justin S Hatchimonji, Elinore J Kaufman, Catherine E Sharoky, Brian P Smith, Daniel N Holena

Open access · greenAbstract read
In one paragraph

Article in Surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
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

3 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
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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

6 authors at 1 institution in 1 country.

Lucy W MaCollege of Arts and Sciences, University of Pennsylvania, Philadelphia, PA. Electronic address: lucywma@sas.upenn.edu.
Justin S HatchimonjiDivision of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Elinore J KaufmanThe Penn Injury Science Center at the University of Pennsylvania, Philadelphia, PA.
Catherine E SharokyDivision of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Brian P SmithDivision of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Daniel N HolenaDivision of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; The Penn Injury Science Center at the University of Pennsylvania, Philadelphia, PA.
University of Pennsylvania · US

Funding

Reducing mortality attributable to cardiac and pulmonary complications after traumatic injury: understanding the role of failure-to-rescueK08HL131995 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI HOLENA, DANIEL NORMAN · 2016 to 2018
$509k
NHLBI NIH HHS K08 HL131995
6 · The paper itself

Abstract

backgroundFailure to rescue is defined as death after a complication and has been used to evaluate quality of care in adult trauma patients, but there are no published studies on failure to rescue in pediatric trauma. The aim of this study was to define the relationship among rates of mortality, complications, and failure to rescue at centers caring for pediatric (<18 years of age) trauma patients in a nationally representative database.

methodsWe performed a retrospective cohort study of the 2015 and 2016 National Trauma Data Bank. We included patients <18 years of age with an Injury Severity Score of ≥9. We excluded centers with <50 pediatric patients or that reported no complications. We calculated the complication, failure to rescue, mortality, and precedence rates by center and divided centers into tertiles of mortality. We compared complication and failure-to-rescue rates between high and low tertiles of mortality using the Kruskal-Wallis test.

resultsOf 62,190 patients from 284 centers, 2,204 patients had at least 1 complication for an overall complication rate of 4% (center level 0%-15%), and 120 patients died after a complication for an overall failure-to-rescue rate of 5% (center level 0%-67%). High-mortality centers had both higher failure-to-rescue rates (10% vs 0.6%, P < .001) and higher complication rates (5% vs 4%, P = .001) than lower-mortality hospitals. The overall precedence rate was 15% with a median rate of 0% (interquartile range 0%-25%).

conclusionBoth complication and failure-to-rescue rates are low in the pediatric injury population, but both complication and failure-to-rescue rates are higher at higher-mortality centers. The low overall complication rates and precedence rates likely limit the utility of failure to rescue as a valid center-level metric in this population, but further investigation into individual failure-to-rescue cases may reveal important opportunities for improvement.

Indexed as

Hospital MortalityAdolescentBenchmarkingChildChild, PreschoolDatabases, FactualFailure to Rescue, Health CareFemaleHumansInjury Severity ScoreMaleQuality ImprovementRetrospective StudiesTrauma CentersWounds and Injuries

Identifiers

PMID31072669
PMCPMC6581579
OpenAlexW2944544924

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.