PMID- 20308932
OWN - NLM
STAT- MEDLINE
DCOM- 20110110
LR  - 20220331
IS  - 1529-7535 (Print)
IS  - 1529-7535 (Linking)
VI  - 11
IP  - 5
DP  - 2010 Sep
TI  - Prevalence of adverse events in pediatric intensive care units in the United 
      States.
PG  - 568-78
LID - 10.1097/PCC.0b013e3181d8e405 [doi]
AB  - OBJECTIVES: Selection of relevant patient safety interventions for the pediatric 
      intensive care (PICU) requires identification of the types and severity of 
      adverse events (AEs) and adverse drug events (ADEs) that occur in this setting. 
      The study's objectives were to: 1) determine the rates of AEs/ADEs, including 
      types, severity, and preventability, in PICU patients; 2) identify population 
      characteristics associated with increased risk of AEs/ADEs; 3) develop and test a 
      PICU specific trigger tool to facilitate identification of AEs/ADEs. DESIGN, 
      SETTING, PATIENTS: Retrospective, cross-sectional, randomized review of 734 
      patient records who were discharged from 15 U.S. PICUs between September and 
      December 2005. INTERVENTION: A novel PICU-focused trigger tool for AE/ADE 
      detection. MEASUREMENTS AND RESULTS: Sixty-two percent of PICU patients had at 
      least one AE. A total of 1488 AEs, including 256 ADEs, were identified. This 
      translates to a rate of 28.6 AEs and 4.9 ADEs per 100 patient-days. The most 
      common types of AEs were catheter complications, uncontrolled pain, and 
      endotracheal tube malposition. Ten percent of AEs were classified as 
      life-threatening or permanent; 45% were deemed preventable. Higher adjusted rates 
      of AEs were found in surgical patients (p = .02), patients intubated at some 
      point during their PICU stay (p = .002), and patients who died (p < .001). 
      Surgical patients had higher preventable adjusted AE (p = .01) and ADE rates (p = 
      .02). The adjusted cumulative risk of an AE per PICU day was 5.3% and 1.6% for an 
      ADE alone. There was a 4% increase in adjusted ADEs rates for every year increase 
      in age. CONCLUSIONS: AEs and ADEs occur frequently in the PICU setting. These 
      data provide areas of focus for evidence-based prevention strategies to decrease 
      the substantial risk to this vulnerable pediatric population.
FAU - Agarwal, Swati
AU  - Agarwal S
AD  - Virginia Commonwealth University School of Medicine, Inova Campus, Pediatric 
      Critical Care, Inova Fairfax Hospital for Children, Falls Church, VA, USA. 
      swati.agarwal@inova.org
FAU - Classen, David
AU  - Classen D
FAU - Larsen, Gitte
AU  - Larsen G
FAU - Tofil, Nancy M
AU  - Tofil NM
FAU - Hayes, Leslie W
AU  - Hayes LW
FAU - Sullivan, Janice E
AU  - Sullivan JE
FAU - Storgion, Stephanie A
AU  - Storgion SA
FAU - Coopes, Barbara J
AU  - Coopes BJ
FAU - Craig, Vicki
AU  - Craig V
FAU - Jaderlund, Christine
AU  - Jaderlund C
FAU - Bisarya, Hema
AU  - Bisarya H
FAU - Parast, Layla
AU  - Parast L
FAU - Sharek, Paul
AU  - Sharek P
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Pediatr Crit Care Med
JT  - Pediatric critical care medicine : a journal of the Society of Critical Care 
      Medicine and the World Federation of Pediatric Intensive and Critical Care 
      Societies
JID - 100954653
SB  - IM
CIN - Pediatr Crit Care Med. 2010 Sep;11(5):632-3. PMID: 20823738
MH  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Child
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - Drug-Related Side Effects and Adverse Reactions/classification/epidemiology
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Infant
MH  - Intensive Care Units, Pediatric/*statistics & numerical data
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Medical Errors/classification/prevention & control/*statistics & numerical data
MH  - Medication Errors/statistics & numerical data
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sex Distribution
MH  - United States/epidemiology
EDAT- 2010/03/24 06:00
MHDA- 2011/01/11 06:00
CRDT- 2010/03/24 06:00
PHST- 2010/03/24 06:00 [entrez]
PHST- 2010/03/24 06:00 [pubmed]
PHST- 2011/01/11 06:00 [medline]
AID - 10.1097/PCC.0b013e3181d8e405 [doi]
PST - ppublish
SO  - Pediatr Crit Care Med. 2010 Sep;11(5):568-78. doi: 10.1097/PCC.0b013e3181d8e405.