Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe.
Details
Serval ID
serval:BIB_9A538C4C2167
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe.
Journal
The Lancet. Respiratory medicine
Working group(s)
APRICOT Group of the European Society of Anaesthesiology Clinical Trial Network
Contributor(s)
Klimscha W., Konecny R., Luntzer R., Morawk-Wintersperger U., Neiger F., Rustemeyer L., Breschan C., Frey D., Platzer M., Germann R., Oeding J., Stoegermüller B., Ziegler B., Brotatsch P., Gutmann A., Mausser G., Messerer B., Toller W., Vittinghoff M., Zangl G., Seidel-Ahyai N., Hochhold C., Kroess R., Paal P., Cnudde S., Coucke P., Loveniers B., Mitchell J., Kahn D., Pirotte T., Pregardien C., Veyckemans F., Coppens M., De Hert S., Heyse B., Neckebroek M., Parashchanka A., Van Limmen J., Van Den Eynde N., Vanpeteghem C., Wyffels P., Lalot M., Lechat J.P., Stevens F., Casaer S., De Groote F., De Pooter F., De Villé A., Gerin M., Magasich N., Sanchez Torres C., Van Deenen D., Berghmans J., Himpe D., Roofthooft E., Joukes E., Smitz C., Van Reeth V., Huygens C., Lauweryns J., De Smet K., Najafi N., Poelaert J., Van de Velde A., Van Mossevelde V., Bekavac I., Butkovic D., Heli Litvic D., Kerovec Soric I., Maretic H., Moscatello D., Popovic L., Micici S., Stuck Tus I., Kalagac Fabris L., Simurina T., Sulen N., Kesic-Valpotic G., Djapic D., Žurek J., Jureckova L., Mackova I., Skacel M., Weinlichova S., Divák J., Frelich M., Urbanec R., Biskupova V., Mixa V., Pavlickova J., Afshari A., Bøttger M., Ellekvist M.B., Johansen M., Ingeborg Madsen B., Christian Nilsson J., Schousboe B.M., Clausen N.G., Hansen T.G., Phaff Steen N., Ilmoja M.L., Tonise V., Karjagin J., Kikas R., Isohanni M., Lyly A., Takala A., Happo J., Kiviluoma K., Martikainen K., Aantaa R., Manner T., Vilo S., Amory C., Ludot H., Lambotte P., Busche R., Jacqmarcq O., Lejus C., Corouge J., Erb C., Garrigue D., Gillet P., Laffargue A., Lambelin V., Le Freche H., Peresbota D., Richart P., Berton J., Chapotte C., Colbus L., Lehousse T., Monrigal J., Baujard C., Roulleau P., Staiti G., Batoz H., Bordes M., Didier A., Hamonic Y., Lagarde S., Nouette-Gaulain K., Semjen F., Zaghet B., Dekens J., Delcuze A., Dupont H., Legrand A., Raffoflandreur C., Audren N., Camus B., Cartal M., Chazelet C., Davin I., Guillier M., Desjeux L., Larcher C., Grein E., Leclercq M., Levitchi R., Rosu L., Simon D., Zang A., Migeon A., Gagey A.C., Bourdaud N., Carre A.C., Duflo F., Riche J.C., Robert P., Druot E., Maupain O., Orliaguet G., Sabau L., Taright H., Uhrig L., Verchere-Montmayeur J., Debrabant L., Pilla C., Podvin A., Roth B., Dahmani S., Julien-Marsollier F., Sabourdin N., Alexandri B., Brezac G., de la Brière F., Hayem C., Lhubat E., Paul Mission J., Rémond C., Dadure C., Maniora M., Marie A., Pirat P., Saour A.C., Sola C., Ecoffey C., Wodey E., Adam C., Standl T., Schindler E., Yamamoto T., Brackhahn M., Eich C.B., Guericke H., Kindermann P., Laschat M., Schink C., Wappler F., Hoehne C., Skordou N., Ulrici J., Jetzek-Zader M., Kienbaum P., Meyer-Treschan T., Picker O., Schaefer M.S., Mielke G., Baethge S., Ramminger A., Bauer M., Bollinger M., Hinz J., Quintel M., Russo S.G., Bauer M., Geil D., Kortgen A., Preussler N.P., Hofmann U., Raber M., Reindl D., Becke K., Oppenrieder K., Schierlinger B., Roth J., Funk W., Fischer T., Gernoth C., Wiefelspütz C., Volger H., Zederer N., Diers A., Huber M., Schorer C., Weyland A., Schwarzkopf K., Grau C., Roth W., Holy R., Mader T., Peter L., Supthut H., Kuehhirt T., Milde A., Fiedler F., Isselhorst C., Grundmann U., Pattar A., Reinert J., Ehm B., Fritzsche K., Gaebler R., Meybohm P., Hein M., Guzman I., Jokinen J., Kranke P., Goebel U., Harris S., Eisner C., Ochsenreiter M., Schoeler M., Thil E., Ellerkmann R., Hoeft A., Neumann C., Weber S., Keilhauer J., Kloessing J., Schramm M., Trieschmann U., Knauss K., Sinner B., Steinmann J., Koessler H., Kalliardou E., Malisiova A., Tsiotou A., Chloropoulou P., Chrysi M., Iordanidou D., Ntavlis M., Boda K.B., Guerin C., Irwin J., Magner C., Nakhjavani S., O'Hare B., Galvin D., Jamil Y., Lesmes C., Barak Y., Fisher H., Kachko L., Katz J., Kirilov D., Levinzon M., Manevich Y., Nekrasov K., Peled E., Sanko E., Schmain D., Sheinkin O., Simhi E., Tarabikin A., Trabkin E., Yagudaev I., Zeitlin Y., Zunser I., Cerutti E., Maddalena Schellino M., Valzan S., Lucia Pinciroli R., Bortone L., Cerati G., Salici F., Bussolin L., Rizzo G., Rossetti F., Marchesini L., Tesoro S., De Lorenzo B., Guarracino F., Kuppers B., Astuto M., Pitino S., Scalisi R., Scordo L., D'Alessandro S., Dei Giudici L., Farinelli I., Lofino G., Marchetti G., Giuseppe Picardo S., Reali S., Vittori A., Antonio Idone F., Sammartino M., Sbaraglia F., Barbera C., Bevilacqua M., Cento V., Disma N., Kotzeva S., Mameli L., Montobbio G., Passariello L., Punzo C., Sileo R., Viacava R., Volpe C., Zanaboni C., Calderini E., Genco D., Neri S., Ottolina D., Camporesi A., Izzo F., Salvo I., Wolfler A., Sanna A., Sciascia A., Stoia P., Guddo A., Lapi M., Ivani G., Longobardo A., Mossetti V., Pedrotti D., Grazzini M., Meneghini L., Metrangolo S., Michelon S., Minardi C., Tognon C., Zadra N., Busi I., Khotcholava M., Guido Locatelli B., Sonzogni V., Starita G., Almenrader N., Aurilio C., Sansone P., Albarello R., Bracci P., Cecini M., Cristina Mondardini M., Pasini L., Vason M., Zani G., Zoppellari R., Pistidda L., Cortegiani A., Maurizio Raineri S., Hasani A., Hashimi M., Ancupans A., Barzdina A., Straume Z., Zundane A., Chlopin M., Gestautaite D., Lukosiene L., Paliokaite E., Razlevice I., Armoniene I., Bernotiene A., Daugelavicius V., Dockiene I., Gaidelyte L., Saviciene N., Krikstaponiene J., Sidlovskaite-Baltake D., Stasevski V., Vaitoskaite A., Gatt D., Mifsud S., Zammit S., Allison C., Aslami H., Eberl S., van Stijn MFM, Stevens M.F., Punt K., van Osch R., Bauwman A., Scholten H., Svircevic V., Adriaens V., Dirckx M., Dogger J., Dons-Sinke I., Machotta A., Moors X., Rad M., Staals L., van der Knijff-van Dortmont A., van der Marel C., Sieben A., van der Zwan T., Veldhuizen M., Alders D., Buhre W., Vermeulen P.M., Engel N., Vossen C., Mahadewsing R., Meijer P., Gerling V., van der Schatte Olivier R., van Doorn T., Vons Mark Hendriks K., Lako S., Jan Scheffer G., Tielens L., Voet M., Absalom A., Bergsma M., Spanjer V., Spanjersberg R., van de Riet Y., Volkers M., de Graaff J.C., Hopman GAJ, Kappen T.H., Hannie J., Megens A.M., Numan S.C., Schouten ANJ, Turner N.M., Van Der Werff DBM, Wensing RTM, Ephraim E., Nolte C., Reikvam T., Fredrik Lund O., Skaaden L., Marthe Ballovarre K., Bakken Boerke W., Grindheim G., Lindenskov PHH, Beate Solas A., Sponheim S., Ullensvang K., Viken O., Marie Drage I., Gymoese Berthelsen K., Anders Kroken B., Bergland U., Pryzmont M., Talalaj M., Wasiluk M., Zalewska D., Damps M., Siemek-Mitela J., Wieczorek P., Juzwa M., Rosada-Kurasinska J., Bartkowska-Sniatkowska A., Cettler M., Kopycinska R., Rudewicz I., Sobczyk J., Wojciechowski D., Baranowski A., Basiewicz E., Mierzewska-Schmidt M., Retka W., Sawicki P., Checinska M., Zielinska M., Zurawska M., Leal T., Mascarenhas C., Pedro Pina A., Joao Susano M., Moniz A., Teresa Rocha M., Calvao Santos C., Domingas Patuleia M., Pereira R., Roxo H., Amaral R., Guedes I., Gomes C., Gonçalves M., Salgado H., Santos M., Rodrigues S., Sa A., Machado E., Pé d'Arca S., Seabra M., Mihaela Gheorghe L., Ivascu C., Moraru-Draghici L., Suvejan M., Babici R., Eniko K., Hogea C., Mihaela D., Nicoleta D., Barbunc D., Maria Nistor A., Stefan V., Catalina Ionescu G., Davidescu I., Teodora Nastase A., Dumitru Rusu F., Badarau V., Cindea I., Moscaliuc M., Olteanu D., Petrescu L., Ceuca D., Galinescu I., Badeti R., Capusan A., Cucui-Cozma C., Popescu B., Cimpeanu L., Birliba M.P., Miulescu M., Balamat S., Gurita A., Ilie L., Mocioiu G., Pick D., Sirghie R., Tabacaru R., Trante I., Gurita A., Horhota L., Bandrabur D., Ciobanu T., Cuciuc V., Munteanu V., Olaru V., Paiu C., Savu A., Trifan O., Elena Malos A., Glazunov A., Ivanov A., Poduskov E., Popov A., Guskov I., Lugovoy A., Nechaev V., Ovezov A., Basov M., Kochkin V., Lazarev V., Chizhov D., Ostreikov I., Tolasov K., Budic I., Marjanovic V., Draskovic B., Pandurov M., Simin J., Dolinaj V., Janjevic D., Mandras A., Mircetic M., Petrovic S., Rebac V., Slavkovic B., Stevanovic V., Velcev A., Knezevic M., Milojevic I., Puric S., Simic I., Stevic M., Stranjanac V., Simic D., Cabanova B., Hanula M., Grynyuk A., Berger J., Cerne U., Nastran A., Pirc D., Popic R., Stupnik S., Rubio P., Del Río C., Benito P., Pino G., Gutierrez I., Gutierrez Valcarcel A., León Carsi I., Perez Garcia A., López Galera S., Marco Valls J., Ricol Lainez L., Vallejo Tarrat A., Artes D., Banus E., Chirichiello L., De Abreu L., De Josemaria B., Helena Gaitan M., Garces A., Lazaro J.J., Manen Berga F., Molies D., Monclus E., Navaro M., Pamies C., Perelló M., Prat M., Ribo L., Angeles Sanz M., Serrano S., Sola Ruiz E., Anuncia Escontrela Rodríguez B., Maria Gago Martinez A., Martínez Ruiz A., De La Cruz Benito F., Gabilondo Garcia G., Martinez Maldonado E., Noriega B., Oller Duque L., Olmos Mendez A., Perez-Ferrer A., Reinoso Barbero F., Acevedo Bambaren I., Domínguez F., Franco T., Jiménez A., Melero A., Feliu M., García I., Montferrer N., Munar F., Muro C., Nuño R., Perera R., Schmucker E., Börjesson G., Gillberg L., Castellheim A., Sandström K., Bauer A., Roos T., Hedlund L., Boegli Y., Dolci M., Marcucci C., Spahr-Schopfer I., Habre W., Pellegrini M., Book M., Errass L., Riggenbach C., Casutt M., Hölzle M., Hurni T., Jöhr M., Mauch J., Anselmi L., Anselmi I., Jacomet A., Oberhauser M., Wossner S., Zettl A., Erb T., Mackiewicz T., Simitzes H., Ozer Y., Takil A., Alanoglu Z., Bermede O., Cakar Turhan K.S., Alkis N., Yildirim Guclu C., Ceyda Meco B., Hatipoglu Z., Ozcengiz D., Begec Z., Ilksen Toprak H., Kendigelen P., Cigdem Tütüncü A., Karadeniz M.S., Seyhan Ozkan T., Sivrikoz N., Kemal Arslantas M., Hizal A., Tore Altun G., Umuroglu T., Baris S., Kazak Bengisun Z., Goncharenko G., Khrapak M., Klymenko T., Pavlenko V., Prysiazhniuk D., Rudio O., Varyvoda M., Vodianytskyi S., Boryshkevych I., Kyselova I., Trikash N., Albokrinov A., Perova-Sharonova V., Sklyar V., Surkov D., Abdelaal A., Barber N., Checuti S., Godsiff L., Johanne L., Simpson J., Underhill H., Diwan R., Kelgeri N., Masip N., Ravi R., Roberts S., Cillis A., Marcus R., Merella F., Love D., Baraggia P., Bird V., Hussey J., Alderson P., Bartholomew K., Moncreiff M., Davidson S., Hare A., Kotecha A., Lee C., Liyanage G., Patel S., Samani A., Abou-Samra M., Boyd M., Hullatt L., Levy D., Pauling M., Sharman S.J., Smith N., Rutherford J., Cavalier A., Locke C., Sage F., Bapat S., Hammerschlag J., Ioannou I., King S., Pegg R., Salota V., Sketcher J., Thadsad M., Zeitlin D., Jack E., Lang C., Ahmed S., Ayyash R., Bari F., Bell S.J., Elizabeth Biercamp C., Briggs S., Gabriella Elena Clement M., Dalton M., Ali Eissa Eid M., Gandhi M., Harmen Herrema I., Khaffaf R., Jeng Min Law S., McClintock J., Ireland N., Majid Saleem M., Smith F., Cohen M., Lee C.A., O'Donahue L., Powell A., Rawlinson E., Snoek A., Weiss K., Wellesley H., Crawford M., Abdel-Hafiz M., Day A., Rajamani B., Saha R., Wright D., Chee L.C., Bew S., Homer R., Malarkkan N., Wolfe Barry J., Angadi P., Cagney B., De Melo E., Dekker E., Helm E., Jones G., Peiris K., Russell W., Slater P., Sodhi P., Browning M., Phillips T., Van Hecke R., Muir V., Singh P., Soskova T., Cumming C., Farquharson P., Pearson K., Shaw N., Whiteside J., Whyte E., Byers G., Davies K., Engelhardt T., Faliszewski I., Johnston G., Kaufmann N., Kusnirikova Z., Wilson G., Carachi P., Makin A., Foster B., Lipczynski D., Mawer R., Rutherford W., Rogerson D., Rushman S., Taylor C., Tomlinson W., Dix P., Woodward T., Bell G., Boyle D., Cloherty M., Cullen J., Cullen P., Fairgrieve R., Ghent R., Glasgow R., Gordeeva E., Harden A., Hivey S., Jerome K., McKee L., Morton N., Pribul V., Sinclair J., Steiner M., Steward H., Sweeney L., Thomson W., Whiteside J., Dalton A., Ross M., Smith C., Allen C., Anders N., Barlow V., Bassett M., Darwin L., Davison R., Diacono J., Hobbs A., Hutchinson A., Lomas B., Lonsdale H., Nasser L., Oshan V., Patel P., Raistrick C., Scott-Warren V., Talbot L., Wai C., Childs S., Dickinson M., Bloomfield T., Garrioch S., Watson K., Gaynor J., Harrison R., Lee J., Blythe E., Dorman T., Eissa A., Ellwood J., Gooch I., Hearn R., Hodgetts V., John R., Kirton C., Ladak N., Morgan J., Plant N., Shepherd E., Short J., Stack C., Steel S., Taylor M., Thomas D., Wilson C., Wilson-Smith E., Bradbury C.L., Hussain N., Mayell A., Mesbah A., Qureshi A., Vaidyanath C., Geary T., Hawksworth C., Parasuraman T., Perry N., Banerjee I., Barr K., Butler P., Davies J., Flewin L., Gande R., Montague J., Plumb J., Pratt T., Sutherland P., Taylor M., Vail H., Wilkins A., Hunter C., Russell S., Thomas A., Mifsud M., Strachan D., Leva B., Plichon B., Harlet P.
ISSN
2213-2619 (Electronic)
ISSN-L
2213-2600
Publication state
Published
Issued date
05/2017
Peer-reviewed
Oui
Volume
5
Number
5
Pages
412-425
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors.
The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760.
Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0-5·5) with an incidence of respiratory critical events of 3·1% (2·9-3·3). Cardiovascular instability occurred in 1·9% (1·7-2·1), with an immediate poor outcome in 5·4% (3·7-7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86-0·90; p<0·0001), medical history, and physical condition (1·60, 1·40-1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981-0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97-0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers.
This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia.
European Society of Anaesthesiology.
The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760.
Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0-5·5) with an incidence of respiratory critical events of 3·1% (2·9-3·3). Cardiovascular instability occurred in 1·9% (1·7-2·1), with an immediate poor outcome in 5·4% (3·7-7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86-0·90; p<0·0001), medical history, and physical condition (1·60, 1·40-1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981-0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97-0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers.
This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia.
European Society of Anaesthesiology.
Keywords
Adolescent, Age Factors, Anesthesia, General/adverse effects, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/etiology, Child, Child, Preschool, Clinical Competence, Drug Hypersensitivity/epidemiology, Drug Hypersensitivity/etiology, Europe/epidemiology, Female, Health Status, Hospitals/statistics & numerical data, Humans, Incidence, Infant, Infant, Newborn, Intraoperative Complications/epidemiology, Intraoperative Complications/etiology, Male, Nervous System Diseases/epidemiology, Nervous System Diseases/etiology, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Prospective Studies, Respiratory Tract Diseases/epidemiology, Respiratory Tract Diseases/etiology
Pubmed
Web of science
Create date
01/11/2018 17:27
Last modification date
15/12/2022 6:50
Usage data
