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Adverse events in hospitalized paediatric patients: a systematic review and a meta-regression analysis
Paola Berchialla1, Giacomo Scaioli, Stefano Passi
1Department of Clinical and Biological Sciences, University of Torino, Torino, Italy.
Insights
Paediatric adverse events (AEs) occur in 2.0% of hospitalized children. Methodological differences, particularly event detection timing, significantly impact reported AE incidence, highlighting the need for more homogeneous studies.
Area of Science:
- Pediatric Health
- Patient Safety
- Clinical Epidemiology
Background:
- Adverse events (AEs) in hospitalized children are a significant concern.
- Understanding the incidence and variability of AEs is crucial for improving child safety.
Purpose of the Study:
- To determine the incidence of paediatric adverse events (AEs).
- To assess differences in reported AE incidence across studies.
- To identify methodological factors contributing to study result variations.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Cochrane Library (Nov 2012-Jan 2013).
- Inclusion of studies from 1970 onwards evaluating AE incidence in hospitalized pediatric patients (min. 1000 records per study).
- Data extraction on data collection methods, study design, hospital type, and AE detection time frame; analysis of AE incidence and preventability.
Main Results:
- The pooled incidence of paediatric adverse events (AEs) was 2.0% (95% CI: 1.3-3.0%).
- The time frame for detecting events was the only methodological factor significantly affecting reported AE incidence (P<0.0001).
- The pooled incidence of preventable AEs was 46.2% (95% CI: 35.3-57.5%), with substantial variability.
Conclusions:
- Adverse events (AEs) represent a major public health issue in paediatrics.
- Considerable variation exists in reported AE and preventable AE incidence, despite a consistent definition.
- Future research requires more methodologically homogeneous studies with detailed healthcare standards and organization to guide prevention efforts effectively.
Rationale, Aims And Objectives:
To gain insight into the incidence of paediatric adverse events (AEs); to assess if there are significant differences among study results and to what extent methodological issues can explain them.
Methods:
From November 2012 to January 2013, systematic literature searches were conducted on PubMed, Scopus and the Cochrane Library. We selected studies from 1970 onwards that evaluated the incidence of AEs in hospitalized paediatric patients and included a minimum of 1000 patient records with the same definition of AE. Studies that reported only specific AEs or only a specific ward were not considered. Data were extracted on the method of data collection, study design, type of hospital, and the timing of the AE in relation to its discovery and the index admission (time frame). AE incidence and preventability were considered.
Results:
The pooled incidence of AEs was 2.0% (95% CI: 1.3-3.0%). Five methodological differences among studies were taken into account. Only the time frame of detected events had a statistically significant effect on the incidence of AEs (P<0.0001). The pooled incidence of preventable AEs was 46.2% (95% CI: 35.3-57.5%) with a high variability among studies.
Conclusions:
Our meta-analysis confirms that AEs are a major public health issue. Although studies use the same definition of AE, the reported incidence of AEs and preventable AEs varied considerably. To direct prevention efforts properly, studies methodologically more homogeneous and more detailed about the standard of health care provided and the health system organization are needed.
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