PMID- 26594830
OWN - NLM
STAT- MEDLINE
DCOM- 20171113
LR  - 20180201
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Linking)
VI  - 62
IP  - 6
DP  - 2016 Jun
TI  - Adverse Events Following Gastrointestinal Endoscopy in Children: Classifications, 
      Characterizations, and Implications.
PG  - 828-33
LID - 10.1097/MPG.0000000000001038 [doi]
AB  - OBJECTIVE: To conduct a comprehensive study of postendoscopic adverse events 
      (AEs) in children, categorizing them by the level of intervention required. 
      BACKGROUND: Previous studies of endoscopic AE in children have focused on 
      intraprocedural and short-term outcomes, such as bleeding, perforation, and 
      infection, and may underestimate the incidence of AEs. DESIGN: Prospective 
      observational study tracking AEs in pediatric patients within 72 hours of an 
      endoscopic procedure. SETTING: Single-center study performed at an academic, 
      tertiary care, free-standing children's hospital over a 48-month period, from 
      July 2010 through June 2014. PATIENTS AND INTERVENTIONS: Of 9577 pediatric 
      endoscopic procedures, cases identified as having an AE during or following 
      endoscopy were subject to additional chart review for abstraction of relevant 
      data. MAIN OUTCOME MEASUREMENTS: Type, severity, and subsequent interventions of 
      AEs were the primary outcome measures. Events were categorized by severity grade, 
      with grade 1, no intervention; grade 2, outpatient evaluation; grade 3, 
      hospitalization or repeat endoscopy; grade 4, surgery or intensive care unit 
      admission; and grade 5, death. RESULTS: In total, 249 endoscopic AEs were 
      recognized of 9577 procedures performed, yielding a rate of 2.6%. Of these, 160 
      were identified to result in medical evaluation and costs (>/=grade 2) for a rate 
      of 1.7%. Rates of endoscopic AE after advanced or interventional endoscopic 
      procedures were higher, with 65 of 1167 events, resulting in a total AE rate of 
      5.6% and a rate of 4.4% for AE >/= grade 2. There were 10 cases of significant 
      bleeding (0.1%), 9 cases of infection (0.09%), and 12 cases of perforation 
      (0.13%), primarily occurring with advanced/interventional procedures. 
      LIMITATIONS: Single-center study, lack of standardized criteria for ED referral. 
      CONCLUSIONS: AEs presenting within 72 hours of endoscopy and resulting in medical 
      intervention, occur more commonly than previously recognized in children. 
      Standardized postendoscopy surveillance systems and definitions of AEs are 
      needed.
FAU - Kramer, Robert E
AU  - Kramer RE
AD  - Department of Pediatrics, Digestive Health Institute, University of Colorado 
      School of Medicine/Children's Hospital Colorado, Aurora.
FAU - Narkewicz, Michael R
AU  - Narkewicz MR
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
SB  - IM
MH  - Child
MH  - Endoscopy, Gastrointestinal/*adverse effects
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Prospective Studies
EDAT- 2015/11/26 06:00
MHDA- 2017/11/14 06:00
CRDT- 2015/11/24 06:00
PHST- 2015/11/24 06:00 [entrez]
PHST- 2015/11/26 06:00 [pubmed]
PHST- 2017/11/14 06:00 [medline]
AID - 10.1097/MPG.0000000000001038 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2016 Jun;62(6):828-33. doi: 
      10.1097/MPG.0000000000001038.