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  • Title: Retrospective audit of unplanned admissions to pediatric high dependency and intensive care after surgery.
    Author: Gibson AR, Limb J, Bell G.
    Journal: Paediatr Anaesth; 2014 Apr; 24(4):372-6. PubMed ID: 24417703.
    Abstract:
    BACKGROUND: Unplanned admissions to intensive care after surgery are a recommended clinical indicator of patient safety in the perioperative period and are validated to reflect both surgical and anesthesia-related complications. OBJECTIVES: To determine the rate and reasons for unplanned admissions to high dependency (HDU) and pediatric intensive care (PICU) following noncardiac surgery. METHODS: Data, including diagnosis, operation, and history of presenting complaint, were retrieved from electronic HDU and PICU data and hospital records for a 5-year period. All cases were individually reviewed by two pediatric anesthetists to identify unplanned admissions along with their urgency, source, and cause. RESULTS: During the study period, 53,876 procedures were performed resulting in 319 unplanned admissions to HDU/PICU, a rate of 0.6%. Of these, 108 (34%) were related to complications of anesthesia. The rate of unplanned admission to HDU/PICU secondary to a complication of anesthesia was therefore 0.2%. Emergency procedures and procedures involving a shared airway were particular risk factors for admission. CONCLUSION: The rate of unplanned admission to HDU/PICU is low and is comparable to previously published data. The high number of admissions following procedures involving a shared airway may represent patient-related factors and the case mix at this hospital. However, such a finding has prompted a combined ENT and anesthetic review of the care pathway for children with problems following airway instrumentation.
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