Pediatric Center for Education and Research on Therapeutics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
J Hosp Med. 2013 Jul;8(7):390-3. doi: 10.1002/jhm.2058. Epub 2013 Jun 7.
Our objective was to describe the prevalence and nature of adverse medical device events (AMDEs) in tertiary care children's hospitals. In our retrospective cohort study of patients at 44 children's hospitals in the Pediatric Health Information System (PHIS), we included all inpatient stays with an AMDE-related diagnosis from January 1, 2004 to December 31, 2011. We identified AMDEs by diagnoses that specified a device in their definition. We included events present on admission as well as those complicating hospital stays. We described the characteristics of these admissions and patients, and stratified analysis by device category and presence of a complex chronic condition. Of 4,115,755 admissions in the PHIS database during the study period, 136,465 (3.3%) had at least 1 AMDE. Vascular access and nervous system devices together represented 44.4% of pediatric AMDE admissions. The majority (75.5%) of AMDE admissions were of children with complex chronic conditions. The most common age group was patients aged 2 years or less at the time of their first AMDE-related admission. AMDEs occur commonly in a population cared for in tertiary children's hospitals. Research to more specifically delineate AMDEs and their predictors are next steps to understand and improve device safety in children.
我们的目的是描述三级儿童医院不良医疗器械事件(AMDEs)的流行情况和性质。在对儿科健康信息系统(PHIS)中 44 家儿童医院的患者进行回顾性队列研究中,我们纳入了 2004 年 1 月 1 日至 2011 年 12 月 31 日期间所有因 AMDE 相关诊断而住院的患者。我们通过明确规定设备的诊断来识别 AMDEs。我们纳入了入院时存在的以及那些使住院复杂化的事件。我们描述了这些入院和患者的特征,并按设备类别和复杂慢性疾病的存在进行分层分析。在研究期间 PHIS 数据库中的 4115755 次住院中,有 136465 次(3.3%)至少发生了 1 次 AMDE。血管通路和神经系统设备共同占儿科 AMDE 住院的 44.4%。大多数(75.5%)AMDE 住院患者患有复杂的慢性疾病。最常见的年龄组是首次发生与 AMDE 相关的入院时年龄在 2 岁或以下的患者。AMDEs 在三级儿童医院治疗的人群中很常见。下一步是研究更具体地描述 AMDEs 及其预测因素,以了解和提高儿童的设备安全性。