Observational studyCritical care explorations2026
The Vigilance Gradient: Nine Years of Adverse Event Trends in Pediatric Critical Care.
Observational study in Critical care explorations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Erratum: The Vigilance Gradient: Eleven Years of Adverse Event Trends in Pediatric Critical Care: Erratum.Critical care explorations · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine 11-year trends in adverse events (AEs) in a pediatric critical care unit (PCCU), assess the impact of the COVID-19 pandemic on patient safety, and evaluate associations between patient acuity and AE severity.
designRetrospective cohort study using interrupted time series analyses and mixed-effects multinomial regression.
settingA single-center PCCU monitored via the Adverse Event Management System from January 2013 to December 2023. PATIENTS: A total of 7290 critically ill and injured pediatric patients admitted to the PCCU over the study period.
interventionsNone (observational study). Exposure variables included the COVID-19 pandemic period, invasive mechanical ventilation and noninvasive ventilation. MEASUREMENTS AND MAIN
resultsDemographics, length of stay (LoS), disposition, and AE severity were assessed. The baseline AE rate was 11.94 events per 100 cases. At pandemic onset, AE rates rose by 5.20 events per 100 cases (p = 0.004), then declined 0.81 events per 100 cases quarterly (p = 0.010). Post-pandemic, rates increased 1.94 events per 100 cases quarterly (p = 0.009). LoS decreased 0.01 days quarterly pre-pandemic (p = 0.009), was stable during the pandemic, then increased 0.25 days quarterly post-pandemic (p = 0.033). Higher Pediatric Index of Mortality 2 scores were associated with fewer "near miss" events and more "MinModSev" (minimal, moderate, or severe) AEs. Both mechanical ventilation (p = 0.039) and noninvasive ventilation (p = 0.015) increased the odds of "MinModSev" AEs.
conclusionsThis PCCU experienced a transient increase in AEs during COVID-19, followed by recovery and a post-pandemic rise in both AE rates and LoS. Higher illness severity and respiratory support were associated with more severe AEs. These findings underscore the importance of data-driven monitoring systems to sustain patient safety during and after healthcare crises.
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