PMID- 29946855
OWN - NLM
STAT- MEDLINE
DCOM- 20180907
LR  - 20240329
IS  - 1432-1076 (Electronic)
IS  - 0340-6199 (Print)
IS  - 0340-6199 (Linking)
VI  - 177
IP  - 9
DP  - 2018 Sep
TI  - The occurrence of adverse events in low-risk non-survivors in pediatric intensive 
      care patients: an exploratory study.
PG  - 1351-1358
LID - 10.1007/s00431-018-3194-y [doi]
AB  - We studied the occurrence of adverse events (AEs) in low-risk non-survivors 
      (LNs), compared to low-risk survivors (LSs), high-risk non-survivors (HNs), and 
      high-risk survivors (HSs) in two pediatric intensive care units (PICUs). The 
      study was performed as a retrospective patient record review study, using a 
      PICU-trigger tool. A random sample of 48 PICU patients (0-18 years) was chosen, 
      stratified into four subgroups of 12 patients: LNs, LSs, HNs, and HSs. Primary 
      outcome was the occurrence of AEs. The severity, preventability, and nature of 
      the indentified AEs were determined. In total, 45 AEs were found in 20 patients. 
      The occurrence of AEs in the LN group was significantly higher compared to that 
      in the LS group and HN group (AE occurrence: LN 10/12 patients, LS 1/12 patients; 
      HN 2/12 patients; HS 7/12 patients; LN-LS difference, p < 0.001; LN-HN 
      difference, p < 0.01). The AE rate in the LN group was significantly higher 
      compared to that in the LS and HN groups (median [IQR]: LN 0.12 [0.07-0.29], LS 0 
      [0-0], HN 0 [0-0], and HS 0.03 [0.0-0.17] AE/PICU day; LN-LS difference, 
      p < 0.001; LN-HN difference, p < 0.01). The distribution of the AEs among the 
      four groups was as follows: 25 AEs (LN), 2 AEs (LS), 8 AEs (HN), and 10 AEs (HS). 
      Fifteen of forty-five AEs were preventable. In 2/12 LN patients, death occurred 
      after a preventable AE. CONCLUSION: The occurrence of AEs in LNs was higher 
      compared to that in LSs and HNs. Some AEs were severe and preventable and 
      contributed to mortality. What is Known: * 59-76% of all PICU patients encounter 
      at least one adverse event during their PICU stay. * It is unknown if adverse 
      events play a role in death of low-risk PICU patients. What is New: * In low-risk 
      PICU non-survivors, occurrence of adverse events is higher compared to low-risk 
      PICU survivors and to high-risk PICU non-survivors. * Severe and preventable 
      adverse events occur in low-risk PICU non-survivors, some contributing to 
      mortality.
FAU - Verlaat, Carin W
AU  - Verlaat CW
AUID- ORCID: 0000-0001-9023-9725
AD  - Department of Intensive Care, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, 
      The Netherlands. carin.verlaat@radboudumc.nl.
FAU - van der Starre, Cynthia
AU  - van der Starre C
AD  - Department of Neonatal and Pediatric Intensive Care, Erasmus University Medical 
      Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
FAU - Hazelzet, Jan A
AU  - Hazelzet JA
AD  - Department of Public Health, Erasmus University Medical Center-Sophia Children's 
      Hospital, Rotterdam, The Netherlands.
FAU - Tibboel, Dick
AU  - Tibboel D
AD  - Department of Pediatric Intensive Care, Erasmus Medical Center-Sophia Children's 
      Hospital, Rotterdam, The Netherlands.
FAU - van der Hoeven, Johannes
AU  - van der Hoeven J
AD  - Department of Intensive Care, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, 
      The Netherlands.
FAU - Lemson, Joris
AU  - Lemson J
AD  - Department of Intensive Care, Radboud Institute for Health Sciences, Radboud 
      University Medical Center, P.O. Box 9101, Internal Post 709, 6500 HB, Nijmegen, 
      The Netherlands.
FAU - Zegers, Marieke
AU  - Zegers M
AD  - Department of Intensive Care and IQ Healthcare, Radboud Institute for Health 
      Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20180626
PL  - Germany
TA  - Eur J Pediatr
JT  - European journal of pediatrics
JID - 7603873
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Infant
MH  - Intensive Care Units, Pediatric/*statistics & numerical data
MH  - Male
MH  - Medical Errors/*statistics & numerical data
MH  - Patient Safety/statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survivors/*statistics & numerical data
PMC - PMC6096770
OTO - NOTNLM
OT  - (P ediatric) intensive care
OT  - Adverse events
OT  - Complications
OT  - Health care quality
OT  - Hospital
OT  - Outcome
OT  - Patient safety
OT  - Trigger tool
COIS- CONFLICT OF INTEREST: The authors declare that they have no conflicts of 
      interest. INFORMED CONSENT AND ETHICS: The study protocol has been presented to 
      the Medical Ethical Committee of the Radboud University Medical Center in 
      Nijmegen (registration number: 2016-2829). The committee judged that ethical 
      approval was not required under Dutch national law. Data were anonymized and 
      handled according to the principles of good clinical practice. No informed 
      consent was obtained.
EDAT- 2018/06/28 06:00
MHDA- 2018/09/08 06:00
PMCR- 2018/06/26
CRDT- 2018/06/28 06:00
PHST- 2018/03/05 00:00 [received]
PHST- 2018/06/12 00:00 [accepted]
PHST- 2018/05/07 00:00 [revised]
PHST- 2018/06/28 06:00 [pubmed]
PHST- 2018/09/08 06:00 [medline]
PHST- 2018/06/28 06:00 [entrez]
PHST- 2018/06/26 00:00 [pmc-release]
AID - 10.1007/s00431-018-3194-y [pii]
AID - 3194 [pii]
AID - 10.1007/s00431-018-3194-y [doi]
PST - ppublish
SO  - Eur J Pediatr. 2018 Sep;177(9):1351-1358. doi: 10.1007/s00431-018-3194-y. Epub 
      2018 Jun 26.