Evidence map›Paper›PMID 38348499›Full record

ArticleJournal of hospital medicine2024

Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes.

Megan E Collins, Matt Hall, Samir S Shah, Matthew J Molloy, Paul L Aronson, Jillian M Cotter, Michael J Steiner, Elisha McCoy, Michael J Tchou, John R Stephens and 1 more

Open access · bronzeAbstract read
In one paragraph

Article in Journal of hospital medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 97% 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

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Article
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

11 authors at 8 institutions in 1 country.

Megan E CollinsDepartment of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.ORCID 0000-0002-6493-0077
Matt HallDepartment of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.ORCID 0000-0001-7778-5887
Samir S ShahDivision of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0001-7902-7000
Matthew J MolloyDivision of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID 0000-0001-6290-568X
Paul L AronsonDepartments of Pediatrics and Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Jillian M CotterUniversity of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.ORCID 0000-0002-7978-9045
Michael J SteinerUniversity of North Carolina, Chapel Hill, North Carolina, USA.
Elisha McCoyDepartment of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Michael J TchouUniversity of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.ORCID 0000-0001-9710-8920
John R StephensUniversity of North Carolina, Chapel Hill, North Carolina, USA.
Jessica L MarkhamDepartment of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.ORCID 0000-0003-1616-7721
Children's Hospital Colorado · USCincinnati Children's Hospital Medical Center · USUniversity of North Carolina at Chapel Hill · USChildren's Hospital Association · USUniversity of Kansas · USUniversity of Missouri–Kansas City · USUniversity of Tennessee Health Science Center · USYale University · US

Funding

Colorado Clinical and Translational Sciences Institute (CCTSI)UM1TR004399 · NCATS · UNIVERSITY OF COLORADO DENVER · PI JANINE A HIGGINS, RONALD J. SOKOL · 2023 to 2026
$30.7M
CTSA K12 Program at University of Colorado DenverK12TR004412 · NCATS · UNIVERSITY OF COLORADO DENVER · PI ELLEN L BURNHAM · 2024 to 2026
$3.2M
Standardizing Antibiotic Prescribing for Children Hospitalized with Infections using Novel Metrics and Electronic Clinical Decision Support ToolsK08HS028845 · AHRQ · CHILDREN'S MERCY HOSP (KANSAS CITY, MO) · PI Jessica Lynn Markham · 2022 to 2026
$742k
AHRQ HHS K08 HS028845NCATS NIH HHS K12 TR004412NCATS NIH HHS UM1 TR004399
6 · The paper itself

Abstract

backgroundPhlebotomy for hospitalized children has consequences (e.g., pain, iatrogenic anemia), and unnecessary testing is a modifiable source of waste in healthcare. Days without blood draws or phlebotomy-free days (PFDs) has the potential to serve as a hospital quality measure.

objectiveTo describe: (1) the frequency of PFDs in children hospitalized with common infections and (2) the association of PFDs with clinical outcomes. DESIGN, SETTINGS AND

participantsWe performed a cross-sectional study of children hospitalized 2018-2019 with common infections at 38 hospitals using the Pediatric Health Information System database. We included infectious All Patients Refined Diagnosis Related Groups with a median length of stay (LOS) >2 days. We excluded patients with medical complexity, interhospital transfers, those receiving intensive care, and in-hospital mortality. MAIN OUTCOME AND MEASURES: We defined PFDs as hospital days (midnight to midnight) without laboratory blood testing and measured the proportion of PFDs divided by total hospital LOS (PFD ratio) for each condition and hospital. Higher PFD ratios signify more days without phlebotomy. Hospitals were grouped into low, moderate, and high average PFD ratios. Adjusted outcomes (LOS, costs, and readmissions) were compared across groups.

resultsWe identified 126,135 encounters. Bronchiolitis (0.78) and pneumonia (0.54) had the highest PFD ratios (most PFDs), while osteoarticular infections (0.28) and gastroenteritis (0.30) had the lowest PFD ratios. There were no differences in adjusted clinical outcomes across PFD ratio groups. Among children hospitalized with common infections, PFD ratios varied across conditions and hospitals, with no association with outcomes. Our data suggest overuse of phlebotomy and opportunities to improve the care of hospitalized children.

Indexed as

PhlebotomyPneumoniaChildCross-Sectional StudiesHospitalsHumansLength of Stay

Identifiers

PMID38348499
PMCPMC11155307
OpenAlexW4391781255

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.