Navigation Links
No greater death risk for children admitted to emergency out-of-hours intensive care
Date:5/2/2013

Children admitted to UK intensive care units in out-of-hours emergencies are at no greater risk of dying than children arriving during normal working hours, according to new research.

However, mortality rates are significantly higher in the winter, even after taking into account added health risks for children in the colder months.

The study, published by researchers at the University of Leeds and the University of Leicester in the Journal of Pediatrics, is the first large-scale analysis of the influence of admission times on deaths in paediatric intensive care units. It was commissioned by the Healthcare Quality Improvement Partnership and carried out by the Paediatric Intensive Care Audit Network (PICANet).

Its findings are an important contribution to the debate on out-of-hours provision in the NHS, with Sir Bruce Keogh, Medical Director of NHS England, calling in February for 7-days-a-week consultant-led care.

Research in 2010 reported that patients admitted for emergency treatment at weekends were up to 10 per cent more likely to die1 and the Royal College of Pediatrics and Child Health warned in April about the large number of children admitted out of hours with serious health problems who did not see a senior paediatrician promptly2.

The new study, based on admissions to 29 paediatric intensive care units between 2006 and 2011, did not find any negative effect for either weekend or night-time emergency admissions.

Dr Roger Parslow, senior lecturer in the University of Leeds' School of Medicine, who co-led the study, said: "This is a very large study of over 86,000 admissions and we are confident that children admitted as an emergency outside normal working hours have the same chance of survival as those admitted in normal working hours."

Dr Parslow added: "Paediatric intensive care units have direct consultant input and dedicated staffing out-of-hours, so proponents of 24/7 consultant care may see this as supporting their case."

Professor Elizabeth Draper, co-principal investigator from the University of Leicester, said: "The consistency of the quality of care provision by all paediatric intensive care units at any time during the week will be very reassuring for the parents of children requiring intensive care."

The researchers did identify a near doubling of mortality risk for children admitted outside normal working hours following a planned admission. This increased risk is likely to be related to children who have undergone lengthy, complicated surgery that carries a higher risk of death.

However, the report also found a statistically significant 13 percent increase in deaths in November, December and January.

"The increase in winter mortality is not due to children being sicker in winter, as we have taken that into account in our analysis as far as possible," Professor Draper said.

That leaves open the possibility that strain on units' resources and staff may be having an effect. Paediatric intensive care units often experience high admissions during winter. In particular, the greater incidence of human respiratory syncytial virus (RSV) in very young children during winter puts pressure on services.

Dr Parslow said: "It is not clear why we are seeing this effect in winter. It could be pressure on services, but it could also be that we are looking at a different mix of patients. When units are under great pressure less seriously ill children may be cared for in other specialist areas in the hospital. That would mean the proportion of children in intensive care with life-threatening problems is greater and it is possible that our risk-adjustment model may not fully take this into account. This is a topic for further research."

Out-of-hours admissions were defined as any admission at the weekend, night time or on a bank holiday. Weekends were defined as any time from Friday, 5 pm to 7 am on Monday morning. Night-time admissions were defined as after 8.00pm and before 8.00am.

The researchers also looked at whether the size of paediatric intensive care units had an effect on mortality rates, but found no statistically significant differences.


'/>"/>

Contact: Chris Bunting
c.j.bunting@leeds.ac.uk
01-133-433-2049
University of Leeds
Source:Eurekalert

Related medicine news :

1. Altec, Premier Document Management Solution Provider, Releases doc-link 3.0 Providing Greater Mobility and Enhanced Usability
2. Women smokers may have greater risk for colon cancer than men
3. Patients with surgical complications provide greater hospital profit-margins
4. Following a Western style diet may lead to greater risk of premature death
5. Older people may be at greater risk for alcohol impairment than teens, according to Baylor Study
6. Golden Tech's Greg Scasny to Present on "How to Build a Successful Business" at Greater Naples Chamber of Commerce on April 13th, 2003 9 am - 12 pm
7. Cancer drug shortages mean higher costs and greater risk for patients
8. Current and past smokers face greater risk for hip replacement failure
9. Autistic children may be at greater risk of suicide ideation and attempts
10. Hospitalizations for congenital heart disease increasing at greater rate among adults than children
11. Heavy moms-to-be at greater risk of c-section
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether it’s ... setting the bar too high can result in disappointment, perhaps even self-loathing. However, those ... goal. , Research from PsychTests.com reveals that behind the tendency to ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was out ... family verbally and physically. , “When something upset him, he couldn’t control his emotions,” remembers ... would throw rocks at my other children and say he was going to kill them. ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San ... Society and the Road To Recovery® program to drive cancer patients to and from ... adults to ensure the highest quality of life and ongoing independence. Getting to ...
(Date:6/24/2016)... New York, NY (PRWEB) , ... June 24, ... ... lifestyle publication Haute Living, is proud to recognize Dr. Barry M. Weintraub as ... believes that “the most beautiful women in the world, and the most handsome ...
(Date:6/24/2016)... ... ... Venture Construction Group (VCG) sponsors Luke’s Wings 5th Annual ... Country Club at 1201 Rockville Pike, Rockville, Maryland, 20852. The event raised funds ... been wounded in battle and their families. Venture Construction Group is a 2016 Silver ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Research and ... Excipients Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), ... Topical, Coating, Parenteral) - Global Forecast to 2021" ... The global pharmaceutical excipients market is projected ... CAGR of 6.1% in the forecast period 2016 to ...
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Global MEMS Devices Medical Market Analysis 2016 - Forecast to ... The report contains up to date financial ... reliable analysis. Assessment of major trends with potential impact on ... dive analysis of market segmentation which comprises of sub markets, ...
(Date:6/23/2016)... 2016 Bracket , a leading clinical trial ... clinical outcomes platform, Bracket eCOA (SM) 6.0, at the ... – 30, 2016 in Philadelphia , Pennsylvania.  ... Assessment product of its kind to fully integrate with RTSM, ... eCOA 6.0 is a flexible platform for electronic clinical outcomes ...
Breaking Medicine Technology: