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Incidence and risk factors of adverse events in pediatric hemato-oncological patients: A cohort study
M Quintero de Charry1, J R Tovar-Cuevas2, H Leon3
1Clínica Imbanaco, Grupo Quirónsalud, Cra. 38 Bis #5B2-04, Cali, Valle, Colombia.
Insights
Pediatric hemato-oncology patients experience moderate, preventable adverse events (AE), with bone marrow transplant (BMT) patients at higher risk. Safety strategies should address BMT patient needs.
Area of Science:
- Pediatric Hematology-Oncology
- Patient Safety
- Clinical Research
Background:
- Pediatric hemato-oncological (HO) patients face high risks of adverse events (AE).
- Limited research exists on AE incidence and risk factors in this vulnerable population.
- Bone marrow transplant (BMT) patients are a subset of HO patients with potentially unique AE profiles.
Purpose of the Study:
- To determine the incidence, type, severity, and preventability of AE in pediatric HO patients.
- To identify patient-specific risk factors associated with AE occurrence.
- To inform targeted safety interventions for pediatric HO care, including BMT.
Main Methods:
- Retrospective cohort study of children under 18 hospitalized in HO or BMT wards in 2016.
- Analysis of AE type, severity, and preventability using absolute and relative frequencies.
- Logistic regression to identify risk factors, including BMT status, sex, comorbidities, and recovery probability.
Main Results:
- 44 out of 114 (38.6%) patients experienced at least one AE.
- The overall AE rate was 2.5 per 100 patient-days, with BMT patients showing a slightly higher rate (2.8).
- Healthcare-associated infections were the most frequent AE; most were moderate and preventable. BMT patient status was the sole independent risk factor (OR=11.5, p<0.001).
Conclusions:
- Adverse events in pediatric hemato-oncology patients are often moderate and preventable.
- Bone marrow transplant patients represent a high-risk group for adverse events.
- Patient safety initiatives must consider the specific vulnerabilities of pediatric HO and BMT patients.
Background:
Pediatric hemato-oncological (HO) patients are highly susceptible to the occurrence of adverse events (AE), nevertheless few research has been done in this field. Our aim was to describe the incidence, type, severity and preventability of AE in these patients, including bone marrow transplant (BMT) patients, and to identify patient's risk factors for having an AE.
Methods:
Retrospective cohort study. Children under 18yo hospitalized at the HO or BMT ward in 2016 were eligible for the study. Type of AE, severity and preventability were described as absolute and relative frequencies. Cumulative incidence of patients with at least one AE (CI_AE) and the rate of occurrence of all AE were calculated. Risk factors (sex, recovery probability, comorbidities and being a BMT patient) were analyzed using logistic regression.
Results:
114 patients were included, 58% were male, average age was 8.7yo and 25 were BMT patients. 44 had at least one AE, with CI_AE of 38.6% (95%CI 29.7-47.5). Overall rate of occurrence of AE was 2.5 cases per 100 patients-day (95%CI 2.15-2.98). For BMT and non-BMT patients they were 2.8 (95%CI 2.2-3.6) and 2.5 (95%CI 1.98-3.1) respectively. Healthcare related infection was the most frequent AE. Most AE were moderate and with high preventability. Being a BMT patient was the only independent factor associated with the occurrence of at least one AE (OR=11.5, p<0.001).
Conclusions:
Our findings suggest that AE tend to be moderate and preventable in HO pediatric patients. BMT patients seem to be at greater risk of having an AE. Strategies focused on patient safety need to account for their specific characteristics.
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