Pediatric perioperative adverse events requiring rapid response: a retrospective case–control study

• DOI: 10.1111/pan.12922
• Publication Date: 2016-05-21T21:42:50Z
• Authors: Laura E. Schleelein; Ariel M. Vincent; Abbas F. Jawad; Eric Y. Pruitt; Genna D. Kreher; Mohamed A. Rehman; Theodora K. Goebel; David E. Cohen; Scott D. Cook‐Sather
• Keywords: Interquartile range

Perioperative pediatric adverse events have been challenging to study within and across institutions due varying definitions, low event rates, incomplete capture.The aim of this was determine perioperative prevalence evaluate associated case characteristics potential contributing factors at an academic quaternary-care center.At the Children's Hospital Philadelphia (CHOP), requiring rapid response assistance are termed Anesthesia Now (AN!) events. They accurately captured entered into a quality improvement database since 2010. Adverse involving open heart cardiac catheterization cases managed separately not included in database. We conducted retrospective case-control utilizing Compurecord (Phillips Healthcare, Andover, MA, USA), EPIC (EPIC, Verona, WI, Chartmaxx (MedPlus, Mason, OH, USA) systems matching AN! noncardiac controls (1 : 2) based on surgical date.From April 16, 2010 September 25, 2012, we documented 213 complex remote sites our main hospital. 0.0043 234) with 95% confidence interval (CI) (0.0037, 0.0049). Respiratory events, primarily laryngospasm, were most common followed by cardiovascular etiology. Median age lower group than controls, 2.86 years (interquartile range 0.94, 10.1) vs 6.20 (2.85, 13.1), P < 0.0001. Odds ratios (with CI) for age, 0.969 (0.941, 0.997); American Society Anesthesiologists physical status, 1.67 (1.32, 2.12); multiple (≥2) services, 2.27 (1.13, 4.55); nonoperating room operating location, 0.240 (0.133, 0.431); attending anesthesiologist's experience, 0.976 (0.959, 0.992) all significant.Decreased increased comorbidities, (vs single) room) decreased staff experience risk which predominantly respiratory origin.