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Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Authors :
Habre, Walid
Disma, Nicola
Virag, Katalin
Becke, Karin
Hansen, Tom G.
Joehr, Martin
Leva, Brigitte
Morton, Neil S.
Vermeulen, Petronella M.
Zielinska, Marzena
Boda, Krisztina
Veyckemans, Francis
Klimscha, Walter
Konecny, Regina
Luntzer, Robert
Morawk-Wintersperger, Ulrike
Neiger, Franz
Rustemeyer, Lydia
Breschan, Christian
Frey, Denise
Platzer, Manuela
Germann, Reinhard
Oeding, Joachim
Stoegermuller, Birgit
Ziegler, Bernhard
Brotatsch, Philipp
Gutmann, Anton
Mausser, Gerlinde
Messerer, Brigitte
Toller, Wolfgang
Vittinghoff, Maria
Zangl, Gregor
Seidel-Ahyai, Natascha
Hochhold, Christoph
Kroess, Ruth
Paal, Peter
Cnudde, Steven
Coucke, Patricia
Loveniers, Birgit
Mitchell, John
Kahn, David
Pirotte, Thierry
Pregardien, Caroline
Coppens, Marc
De Baerdemaeker, Luc
De Hert, Stefan
Heyse, Bjorn
Neckebroek, Martine
Parashchanka, Aliaksandra
Van Limmen, Jurgen
Van Den Eynde, Nancy
Vanpeteghem, Caroline
Wyffels, Piet
Lalot, Michael
Lechat, Jean-Paul
Stevens, France
Casaer, Sari
De Groote, Francoise
De Pooter, Francoise
De Ville, Andree
Gerin, Marc
Magasich, Natalia
Torres, Cristel Sanchez
Van Deenen, Denise
Berghmans, Johan
Himpe, Dirk
Roofthooft, Eva
Joukes, Ellen
Smitz, Carine
Van Reeth, Veronique
Huygens, Christel
Lauweryns, Julie
De Smet, Karen
Najafi, Nadia
Poelaert, Jan
Van de Velde, Anne
Van Mossevelde, Veerle
Bekavac, Ivan
Butkovic, Diana
Litvic, Dubravka Heli
Soric, Ivana Kerovec
Maretic, Hrvoje
Moscatello, Djurdjica
Popovic, Ljiljana
Micic, Slobodan
Tus, Ivana Stuck
Fabris, Lada Kalagac
Simurina, Tatjana
Sulen, Nina
Kesi-Valpotic, Gordana
Djapic, Dajana
Zurek, Jiri
Jureckova, Lucie
Mackova, Iveta
Skacel, Monika
Weinlichova, Stanislava
Divak, Jan
Frelich, Michal
Urbanec, Rene
Biskupova, Vera
Mixa, Vladimir
Pavlickova, Jana
Afshari, Arash
Bottger, Morten
Ellekvist, Marguerite B.
Johansen, Mathias
Madsen, Birgitte Ingeborg
Nilsson, Jens Christian
Schousboe, Birgitte M. B.
Clausen, Nicola G.
Steen, Nick Phaff
Ilmoja, Mari-Liis
Tonise, Virge
Karjagin, Juri
Kikas, Reet
Isohanni, Mika
Lyly, Anniina
Takala, Annika
Happo, Johanna
Kiviluoma, Kai
Martikainen, Kati
Aantaa, Riku
Manner, Tuula
Vilo, Sanna
Amory, Catherine
Ludot, Hugues
Lambotte, Patricia
Busche, Rene
Jacqmarcq, Olivier
Lejus, Corinne
Corouge, Julien
Erb, Christian
Garrigue, Delphine
Gillet, Patricia
Laffargue, Anne
Lambelin, Veronique
Le Freche, Helene
Peresbota, Daliana
Richart, Pierre
Berton, Jerome
Chapotte, Catherine
Colbus, Laurent
Lehousse, Thierry
Monrigal, Jean
Baujard, Catherine
Roulleau, Philippe
Staiti, Giuseppe
Batoz, Helene
Bordes, Maryline
Didier, Anne
Hamonic, Yann
Lagarde, Sylvaine
Nouette-Gaulain, Karine
Semjen, Francois
Zaghet, Brigitte
Dekens, Jacky
Delcuze, Axelle
Dupont, Herve
Legrand, Aurelien
Raffoflandreur, Celine
Audren, Noemie
Camus, Blandine
Cartal, Marielle
Chazelet, Chantal
Davin, Isabelle
Guillier, Marion
Desjeux, Luc
Larcher, Claire
Grein, Elodie
Leclercq, Mickeal
Levitchi, Roxana
Rosu, Lilica
Simon, Dominique
Zang, Aurelien
Migeon, Anne
Gagey, Anne-Charlotte
Bourdaud, Nathalie
Carre, Anne-Charlotte
Duflo, Frederic
Riche, Jean-Claude
Robert, Philippe
Druot, Emilie
Maupain, Olivier
Orliaguet, Gilles
Sabau, Lucie
Taright, Hanna
Uhrig, Lynn
Verchere-Montmayeur, Juliette
Debrabant, Lise
Pilla, Clotaire
Podvin, Alexandre
Roth, Benjamin
Dahmani, Souhayl
Julien-Marsollier, Florence
Sabourdin, Nada
Alexandri, Bogdan
Brezac, Gilles
de la Briere, Francois
Hayem, Catherine
Lhubat, Elizabeth
Mission, Jean Paul
Remond, Charlotte
Dadure, Christophe
Maniora, Maud
Marie, Anais
Pirat, Philippe
Saour, Anne-Charlotte
Sola, Chrystelle
Ecoffey, Claude
Wodey, Eric
Adam, Christian
Standl, Thomas
Schindler, Ehrenfried
Yamamoto, Tomohiro
Brackhahn, Michael
Eich, Christoph Bernhard
Guericke, Holger
Kindermann, Petra
Laschat, Michael
Schink, Cornel
Wappler, Frank
Hoehne, Claudia
Skordou, Natalia
Ulrici, Johanna
Jetzek-Zader, Martin
Kienbaum, Peter
Meyer-Treschan, Tanja
Picker, Olaf
Schaefer, Maximilian S.
Mielke, Golo
Baethge, Sabine
Ramminger, Axel
Bauer, Martin
Bollinger, Matthias
Hinz, Jose
Quintel, Michael
Russo, Sebastian G.
Bauer, Michael
Geil, Dfominik
Kortgen, Andreas
Preussler, Niels-Peter
Hofmann, Ulrich
Raber, Manfred
Reindl, Doris
Oppenrieder, Karin
Schierlinger, Bettina
Roth, Jens
Funk, Wolfgang
Fischer, Thomas
Gernoth, Christian
Wiefelsputz, Christina
Volger, Hauke
Zederer, Nicole
Diers, Anja
Huber, Matthias
Schorer, Clemens
Weyland, Andreas
Schwarzkopf, Konrad
Grau, Catharina
Roth, Winfried
Holy, Rolf
Mader, Thomas
Peter, Laura
Supthut, Hauke
Kuehhirt, Thomas
Milde, Alexander
Fiedler, Fritz
Isselhorst, Carsten
Grundmann, Ulrich
Pattar, Alexander
Reinert, Jennifer
Ehm, Birgit
Fritzsche, Katrin
Gaebler, Ralf
Meybohm, Patrick
Hein, Maximilian
Guzman, Ines
Jokinen, Johanna
Kranke, Peter
Goebel, Ulrich
Harris, Sarah
Eisner, Christoph
Ochsenreiter, Miriam
Schoeler, Michael
Thil, Elke
Ellerkmann, Richard
Hoeft, Andreas
Neumann, Claudia
Weber, Stefan
Keilhauer, Julia
Kloessing, Jan
Schramm, Michael
Trieschmann, Uwe
Knauss, Kristina
Sinner, Barbara
Steinmann, Johannes
Koessler, Herbert
Kalliardou, Evagelia
Malisiova, Anna
Tsiotou, Adelais
Chloropoulou, Pelagia
Chrysi, Mpratzou
Iordanidou, Despoina
Ntavlis, Merkourios
Rarosi, Ferenc
Boda, Krisztina B.
Guerin, Christilynn
Irwin, Janice
Magner, Claire
Nakhjavani, Solmaz
O'Hare, Brendan
Galvin, Deborah
Jamil, Yosry
Lesmes, Carlos
Barak, Yuri
Fisher, Haran
Kachko, Ludmyla
Katz, Jacob
Kirilov, Dmitry
Levinzon, Michael
Manevich, Yair
Nekrasov, Konstantin
Peled, Elia
Sanko, Elena
Schmain, Dmitri
Sheinkin, Olga
Simhi, Eliahu
Tarabikin, Alex
Trabkin, Evelina
Yagudaev, Irena
Zeitlin, Yelena
Zunser, Igor
Habre, Walid
Disma, Nicola
Virag, Katalin
Becke, Karin
Hansen, Tom G.
Joehr, Martin
Leva, Brigitte
Morton, Neil S.
Vermeulen, Petronella M.
Zielinska, Marzena
Boda, Krisztina
Veyckemans, Francis
Klimscha, Walter
Konecny, Regina
Luntzer, Robert
Morawk-Wintersperger, Ulrike
Neiger, Franz
Rustemeyer, Lydia
Breschan, Christian
Frey, Denise
Platzer, Manuela
Germann, Reinhard
Oeding, Joachim
Stoegermuller, Birgit
Ziegler, Bernhard
Brotatsch, Philipp
Gutmann, Anton
Mausser, Gerlinde
Messerer, Brigitte
Toller, Wolfgang
Vittinghoff, Maria
Zangl, Gregor
Seidel-Ahyai, Natascha
Hochhold, Christoph
Kroess, Ruth
Paal, Peter
Cnudde, Steven
Coucke, Patricia
Loveniers, Birgit
Mitchell, John
Kahn, David
Pirotte, Thierry
Pregardien, Caroline
Coppens, Marc
De Baerdemaeker, Luc
De Hert, Stefan
Heyse, Bjorn
Neckebroek, Martine
Parashchanka, Aliaksandra
Van Limmen, Jurgen
Van Den Eynde, Nancy
Vanpeteghem, Caroline
Wyffels, Piet
Lalot, Michael
Lechat, Jean-Paul
Stevens, France
Casaer, Sari
De Groote, Francoise
De Pooter, Francoise
De Ville, Andree
Gerin, Marc
Magasich, Natalia
Torres, Cristel Sanchez
Van Deenen, Denise
Berghmans, Johan
Himpe, Dirk
Roofthooft, Eva
Joukes, Ellen
Smitz, Carine
Van Reeth, Veronique
Huygens, Christel
Lauweryns, Julie
De Smet, Karen
Najafi, Nadia
Poelaert, Jan
Van de Velde, Anne
Van Mossevelde, Veerle
Bekavac, Ivan
Butkovic, Diana
Litvic, Dubravka Heli
Soric, Ivana Kerovec
Maretic, Hrvoje
Moscatello, Djurdjica
Popovic, Ljiljana
Micic, Slobodan
Tus, Ivana Stuck
Fabris, Lada Kalagac
Simurina, Tatjana
Sulen, Nina
Kesi-Valpotic, Gordana
Djapic, Dajana
Zurek, Jiri
Jureckova, Lucie
Mackova, Iveta
Skacel, Monika
Weinlichova, Stanislava
Divak, Jan
Frelich, Michal
Urbanec, Rene
Biskupova, Vera
Mixa, Vladimir
Pavlickova, Jana
Afshari, Arash
Bottger, Morten
Ellekvist, Marguerite B.
Johansen, Mathias
Madsen, Birgitte Ingeborg
Nilsson, Jens Christian
Schousboe, Birgitte M. B.
Clausen, Nicola G.
Steen, Nick Phaff
Ilmoja, Mari-Liis
Tonise, Virge
Karjagin, Juri
Kikas, Reet
Isohanni, Mika
Lyly, Anniina
Takala, Annika
Happo, Johanna
Kiviluoma, Kai
Martikainen, Kati
Aantaa, Riku
Manner, Tuula
Vilo, Sanna
Amory, Catherine
Ludot, Hugues
Lambotte, Patricia
Busche, Rene
Jacqmarcq, Olivier
Lejus, Corinne
Corouge, Julien
Erb, Christian
Garrigue, Delphine
Gillet, Patricia
Laffargue, Anne
Lambelin, Veronique
Le Freche, Helene
Peresbota, Daliana
Richart, Pierre
Berton, Jerome
Chapotte, Catherine
Colbus, Laurent
Lehousse, Thierry
Monrigal, Jean
Baujard, Catherine
Roulleau, Philippe
Staiti, Giuseppe
Batoz, Helene
Bordes, Maryline
Didier, Anne
Hamonic, Yann
Lagarde, Sylvaine
Nouette-Gaulain, Karine
Semjen, Francois
Zaghet, Brigitte
Dekens, Jacky
Delcuze, Axelle
Dupont, Herve
Legrand, Aurelien
Raffoflandreur, Celine
Audren, Noemie
Camus, Blandine
Cartal, Marielle
Chazelet, Chantal
Davin, Isabelle
Guillier, Marion
Desjeux, Luc
Larcher, Claire
Grein, Elodie
Leclercq, Mickeal
Levitchi, Roxana
Rosu, Lilica
Simon, Dominique
Zang, Aurelien
Migeon, Anne
Gagey, Anne-Charlotte
Bourdaud, Nathalie
Carre, Anne-Charlotte
Duflo, Frederic
Riche, Jean-Claude
Robert, Philippe
Druot, Emilie
Maupain, Olivier
Orliaguet, Gilles
Sabau, Lucie
Taright, Hanna
Uhrig, Lynn
Verchere-Montmayeur, Juliette
Debrabant, Lise
Pilla, Clotaire
Podvin, Alexandre
Roth, Benjamin
Dahmani, Souhayl
Julien-Marsollier, Florence
Sabourdin, Nada
Alexandri, Bogdan
Brezac, Gilles
de la Briere, Francois
Hayem, Catherine
Lhubat, Elizabeth
Mission, Jean Paul
Remond, Charlotte
Dadure, Christophe
Maniora, Maud
Marie, Anais
Pirat, Philippe
Saour, Anne-Charlotte
Sola, Chrystelle
Ecoffey, Claude
Wodey, Eric
Adam, Christian
Standl, Thomas
Schindler, Ehrenfried
Yamamoto, Tomohiro
Brackhahn, Michael
Eich, Christoph Bernhard
Guericke, Holger
Kindermann, Petra
Laschat, Michael
Schink, Cornel
Wappler, Frank
Hoehne, Claudia
Skordou, Natalia
Ulrici, Johanna
Jetzek-Zader, Martin
Kienbaum, Peter
Meyer-Treschan, Tanja
Picker, Olaf
Schaefer, Maximilian S.
Mielke, Golo
Baethge, Sabine
Ramminger, Axel
Bauer, Martin
Bollinger, Matthias
Hinz, Jose
Quintel, Michael
Russo, Sebastian G.
Bauer, Michael
Geil, Dfominik
Kortgen, Andreas
Preussler, Niels-Peter
Hofmann, Ulrich
Raber, Manfred
Reindl, Doris
Oppenrieder, Karin
Schierlinger, Bettina
Roth, Jens
Funk, Wolfgang
Fischer, Thomas
Gernoth, Christian
Wiefelsputz, Christina
Volger, Hauke
Zederer, Nicole
Diers, Anja
Huber, Matthias
Schorer, Clemens
Weyland, Andreas
Schwarzkopf, Konrad
Grau, Catharina
Roth, Winfried
Holy, Rolf
Mader, Thomas
Peter, Laura
Supthut, Hauke
Kuehhirt, Thomas
Milde, Alexander
Fiedler, Fritz
Isselhorst, Carsten
Grundmann, Ulrich
Pattar, Alexander
Reinert, Jennifer
Ehm, Birgit
Fritzsche, Katrin
Gaebler, Ralf
Meybohm, Patrick
Hein, Maximilian
Guzman, Ines
Jokinen, Johanna
Kranke, Peter
Goebel, Ulrich
Harris, Sarah
Eisner, Christoph
Ochsenreiter, Miriam
Schoeler, Michael
Thil, Elke
Ellerkmann, Richard
Hoeft, Andreas
Neumann, Claudia
Weber, Stefan
Keilhauer, Julia
Kloessing, Jan
Schramm, Michael
Trieschmann, Uwe
Knauss, Kristina
Sinner, Barbara
Steinmann, Johannes
Koessler, Herbert
Kalliardou, Evagelia
Malisiova, Anna
Tsiotou, Adelais
Chloropoulou, Pelagia
Chrysi, Mpratzou
Iordanidou, Despoina
Ntavlis, Merkourios
Rarosi, Ferenc
Boda, Krisztina B.
Guerin, Christilynn
Irwin, Janice
Magner, Claire
Nakhjavani, Solmaz
O'Hare, Brendan
Galvin, Deborah
Jamil, Yosry
Lesmes, Carlos
Barak, Yuri
Fisher, Haran
Kachko, Ludmyla
Katz, Jacob
Kirilov, Dmitry
Levinzon, Michael
Manevich, Yair
Nekrasov, Konstantin
Peled, Elia
Sanko, Elena
Schmain, Dmitri
Sheinkin, Olga
Simhi, Eliahu
Tarabikin, Alex
Trabkin, Evelina
Yagudaev, Irena
Zeitlin, Yelena
Zunser, Igor
Publication Year :
2017

Abstract

Background 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. Methods 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. Findings 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

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1364918364
Document Type :
Electronic Resource