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A 4-year review of severe pediatric trauma in eastern Ontario: a descriptive analysis.

https://arctichealth.org/en/permalink/ahliterature191929
Source
J Trauma. 2002 Jan;52(1):8-12
Publication Type
Article
Date
Jan-2002
Author
Martin H Osmond
Maureen Brennan-Barnes
Allyson L Shephard
Author Affiliation
Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada. osmond@cheo.on.ca
Source
J Trauma. 2002 Jan;52(1):8-12
Date
Jan-2002
Language
English
Publication Type
Article
Keywords
Accident prevention
Accidental Falls - prevention & control - statistics & numerical data
Accidents, Traffic - prevention & control - statistics & numerical data
Adolescent
Age Distribution
Athletic Injuries - epidemiology - etiology - prevention & control
Child
Child Abuse - prevention & control - statistics & numerical data
Child, Preschool
Craniocerebral Trauma - epidemiology - etiology - prevention & control
Female
Hospitals, Pediatric - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Ontario - epidemiology
Retrospective Studies
Sex Distribution
Time Factors
Trauma Centers - statistics & numerical data
Trauma Severity Indices
Wounds and Injuries - epidemiology - etiology - prevention & control
Abstract
The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.
PubMed ID
11791045 View in PubMed
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Absolute vs relative improvements in congenital diaphragmatic hernia survival: what happened to "hidden mortality".

https://arctichealth.org/en/permalink/ahliterature151056
Source
J Pediatr Surg. 2009 May;44(5):877-82
Publication Type
Article
Date
May-2009
Author
V Kandice Mah
Mohammed Zamakhshary
Doug Y Mah
Brian Cameron
Juan Bass
Desmond Bohn
Leslie Scott
Sharifa Himidan
Mark Walker
Peter C W Kim
Author Affiliation
Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Source
J Pediatr Surg. 2009 May;44(5):877-82
Date
May-2009
Language
English
Publication Type
Article
Keywords
Cohort Studies
Death Certificates
Female
Fetal Death - epidemiology
Fetal Diseases - surgery
Hernia, Diaphragmatic - congenital - embryology - mortality - surgery
Hospital Mortality
Hospitals, Pediatric - statistics & numerical data
Humans
Infant, Newborn
Male
Ontario - epidemiology
Selection Bias
Stillbirth - epidemiology
Survival Analysis
Abstract
The aim of this study is to determine if there has been a true, absolute, or apparent relative increase in congenital diaphragmatic hernia (CDH) survival for the last 2 decades.
All neonatal Bochdalek CDH patients admitted to an Ontario pediatric surgical hospital during the period when significant improvements in CDH survival was reported (from January 1, 1992, to December 31, 1999) were analyzed. Patient characteristics were assessed for CDH population homogeneity and differences between institutional and vital statistics-based population survival outcomes. SAS 9.1 (SAS Institute, Cary, NC) was used for analysis.
Of 198 cohorts, demographic parameters including birth weight, gestational age, Apgar scores, sex, and associated congenital anomalies did not change significantly. Preoperative survival was 149 (75.2%) of 198, whereas postoperative survival was 133 (89.3%) of 149, and overall institutional survival was 133 (67.2%) of 198. Comparison of institution and population-based mortality (n = 65 vs 96) during the period yielded 32% of CDH deaths unaccounted for by institutions. Yearly analysis of hidden mortality consistently showed a significantly lower mortality in institution-based reporting than population.
A hidden mortality exists for institutionally reported CDH survival rates. Careful interpretation of research findings and more comprehensive population-based tools are needed for reliable counseling and evaluation of current and future treatments.
PubMed ID
19433161 View in PubMed
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Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study.

https://arctichealth.org/en/permalink/ahliterature122113
Source
CMAJ. 2012 Sep 18;184(13):E709-18
Publication Type
Article
Date
Sep-18-2012
Author
Anne G Matlow
G Ross Baker
Virginia Flintoft
Douglas Cochrane
Maitreya Coffey
Eyal Cohen
Catherine M G Cronin
Rita Damignani
Robert Dubé
Roger Galbraith
Dawn Hartfield
Leigh Anne Newhook
Cheri Nijssen-Jordan
Author Affiliation
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. anne.matlow@wchospital.ca
Source
CMAJ. 2012 Sep 18;184(13):E709-18
Date
Sep-18-2012
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - statistics & numerical data
Adolescent
Age Factors
Canada
Child
Child, Preschool
Hospitals - statistics & numerical data
Hospitals, Community - statistics & numerical data
Hospitals, Pediatric - statistics & numerical data
Humans
Incidence
Infant
Infant, Newborn
Logistic Models
Medical Errors - statistics & numerical data
Retrospective Studies
Abstract
Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done to describe the epidemiology of adverse events among children in hospital in Canada.
We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals in Canada. We reviewed charts from patients admitted from April 2008 through March 2009, evenly distributed across 4 age groups (0 to 28 d; 29 to 365 d; > 1 to 5 yr and > 5 to 18 yr). In stage 1, nurses and health records personnel who had received training in the use of the Canadian Paediatric Trigger Tool reviewed medical records to detect triggers for possible adverse events. In stage 2, physicians reviewed the charts identified as having triggers and described the adverse events.
A total of 3669 children were admitted to hospital during the study period. The weighted rate of adverse events was 9.2%. Adverse events were more frequent in academic pediatric centres than in community hospitals (adjusted odds ratio [OR] 2.98, 95% confidence interval [CI] 1.65-5.39). The incidence of preventable adverse events was not significantly different between types of hospital, but nonpreventable adverse events were more common in academic pediatric centres (adjusted OR 4.39, 95% CI 2.08-9.27). Surgical events predominated overall and occurred more frequently in academic pediatric centres than in community hospitals (37.2% v. 21.5%, relative risk [RR] 1.7, 95% CI 1.0-3.1), whereas events associated with diagnostic errors were significantly less frequent (11.1% v. 23.1%, RR 0.5, 95% CI 0.2-0.9).
More children have adverse events in academic pediatric centres than in community hospitals; however, adverse events in the former are less likely to be preventable. There are many opportunities to reduce harm affecting children in hospital in Canada, particularly related to surgery, intensive care and diagnostic error.
Notes
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PubMed ID
22847964 View in PubMed
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Analysis of surgical admissions to the Ethio-Swedish Children's Hospital (1984-1988) in Addis Ababa.

https://arctichealth.org/en/permalink/ahliterature37853
Source
Ethiop Med J. 1990 Jan;28(1):15-22
Publication Type
Article
Date
Jan-1990
Author
E. Daniel
G. Melaku
M C Yoo
Y. Agzew
W. Gebre
Author Affiliation
Department of Paediatrics and Child Health, Faculty of Medicine, Addis Ababa University, Ethiopia.
Source
Ethiop Med J. 1990 Jan;28(1):15-22
Date
Jan-1990
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Ethiopia
Hospitals, Pediatric - statistics & numerical data
Hospitals, Special - statistics & numerical data
Humans
Infant
Infant, Newborn
Patient Admission - trends
Retrospective Studies
Surgical Procedures, Operative - mortality
Sweden
Abstract
Surgical problems in children result in significant morbidity and mortality. A retrospective analysis of all surgical patients admitted to the Ethio-Swedish Children's Hospital (ESCH) over a five year period from 1984 to 1988 was made. There were a total of 2,281 surgical patients admitted, accounting for 22% of all hospital admissions (total = 10,364). The gastrointestinal and musculoskeletal systems were the most common systems involved. Acute appendicitis accounted for 13.9% (N = 318), cleft-lip and palate 8% (N = 183), and burns 6.9% (N = 157) of all surgical admissions. Accidents and trauma accounted for 25% of the surgical admissions (N = 564). Of these, the most common conditions were burns, car accidents, accidental falls, and foreign body aspirations. The over all mortality rate was 4% (N = 98). Acute appendicitis, intussusception, acute laryngotracheobronchitis (ALTB), and burns were associated with a high mortality. Of the neonatal admissions, one third died shortly after surgery, probably due to anaesthetic, fluid and electrolyte imbalance. Examination of the general pattern of surgical admissions revealed that many of the conditions were preventable, or amenable to medical therapy if detected early. Health education of the public is therefore necessary in order to reduce the morbidity and mortality of these conditions.
PubMed ID
2307154 View in PubMed
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An analysis of sport-related injuries: British Columbia children's hospital Emergency Department 1999 - 2003.

https://arctichealth.org/en/permalink/ahliterature161626
Source
Int J Inj Contr Saf Promot. 2007 Sep;14(3):192-5
Publication Type
Article
Date
Sep-2007

An epidemiologic study of nosocomial infections in a pediatric long-term care facility.

https://arctichealth.org/en/permalink/ahliterature220603
Source
Am J Infect Control. 1993 Aug;21(4):183-8
Publication Type
Article
Date
Aug-1993
Author
J H Vermaat
E. Rosebrugh
E L Ford-Jones
J. Ciano
J. Kobayashi
G. Miller
Author Affiliation
Bloorview Children's Hospital, Toronto, Ontario, Canada.
Source
Am J Infect Control. 1993 Aug;21(4):183-8
Date
Aug-1993
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Bacterial Infections - classification - complications - epidemiology
Child
Child, Preschool
Cohort Studies
Cross Infection - classification - complications - epidemiology
Hospitals, Chronic Disease - statistics & numerical data
Hospitals, Pediatric - statistics & numerical data
Humans
Incidence
Infant
Infant, Newborn
Infection Control - methods
Ontario - epidemiology
Prospective Studies
Abstract
To determine the incidence of hospital-acquired (nosocomial) infection in pediatric long-term care facilities.
Prospective cohort.
An 87-bed pediatric long-term care facility.
All patients receiving long-term care at Bloorview Children's Hospital during the study period.
Infection developed in 40.1% of patients (n = 456). The nosocomial infection rate per 1000 patient days (mean, 7.84) varied substantially, from 1.66 in May 1988 to 16.37 day in April, 1989. The proportional frequencies of infections were as follows: respiratory, 41.6% (37.0% upper, 4.6% lower); urinary tract, 31.0%; skin, 15.6% (gastric tube site 5.0%, other 10.6%), eyes, 6.4%; gastrointestinal, 3.5%; and other, 1.5%. Of those infections for which an organism was recovered (48.5%), pathogens included Escherichia coli (22.5%), Enterococcus (14.8%), Staphylococcus (14.8%), Streptococcus (11.2%), Klebsiella (10.5%), Pseudomonas (10.1%), Proteus (4.3%), yeast (4.3%), Salmonella (0.7%), Clostridium difficile (0.4%), and other (6.2%).
The incidence and nature of infections in pediatric long-term care facilities differs from those in acute care facilities. Physicians should become familiar with the infection rates in the populations whom they treat. Control requires compliance with currently recognized effective strategies as well as innovative practical approaches to respiratory disease. Behavioral problems related to frequent clean, intermittent catheterization in young adults need to be addressed.
PubMed ID
8239048 View in PubMed
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An observational asthma study alters emergency department use: the Hawthorne effect.

https://arctichealth.org/en/permalink/ahliterature212208
Source
Pediatr Emerg Care. 1996 Apr;12(2):78-80
Publication Type
Article
Date
Apr-1996
Author
R. Zinman
P. Bethune
C. Camfield
E. Fitzpatrick
K. Gordon
Author Affiliation
IWK Children's Hospital Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
Pediatr Emerg Care. 1996 Apr;12(2):78-80
Date
Apr-1996
Language
English
Publication Type
Article
Keywords
Asthma - therapy
Effect Modifier, Epidemiologic
Emergency Service, Hospital - statistics & numerical data - utilization
Hospitals, Pediatric - statistics & numerical data - utilization
Humans
Infant
Nova Scotia
Prospective Studies
Abstract
The objective of this study was to document that an observational study decreases the use of the emergency department (ED) for asthma. Comparison of rates between an audit and prospective period were used at a regional referral pediatric hospital ED. A total of 526 asthma visits from February 12, 1992, to April 10, 1992, were examined in an initial audit and compared to 725 visits during a prospective study from May 16, 1993, to September 29, 1993. A physician check list for medications and follow-up plans was utilized during the prospective study. The rate of repeat visits and admissions was compared between the audit and the prospective periods. In the audit, 422 asthma patients were seen, and there were 68 repeat visits within one week of the initial visit and 153 admissions. For 29 of the 68 repeat visits there was no documentation that medication had been increased after the initial visit. No follow-up plans were recorded in 275 of the 526 visits. During the prospective period 668 children presented to the ED with asthma, and 346 were enrolled into the study on risks for repeat visits. There were 57 repeat visits and 89 admissions. The repeat visit rate during the prospective period was 9 and 8%, respectively, in the enrolled and nonenrolled subjects. The repeat visit and admission rate decreased during the prospective period as compared to during the audit by 39% (P = 0.004) and 58% (P
PubMed ID
8859912 View in PubMed
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An outbreak of CTX-M-15 -producing Escherichia coli, Enterobacter cloacae, and Klebsiella in a children's hospital in Finland.

https://arctichealth.org/en/permalink/ahliterature256922
Source
Scand J Infect Dis. 2014 Mar;46(3):225-30
Publication Type
Article
Date
Mar-2014
Author
Tanja Pasanen
Jari Jalava
Jenni Horsma
Eeva Salo
Mikko Pakarinen
Eveliina Tarkka
Martti Vaara
Päivi Tissari
Author Affiliation
From the Division of Clinical Microbiology, HUSLAB, Helsinki University Hospital , Helsinki.
Source
Scand J Infect Dis. 2014 Mar;46(3):225-30
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Child
Disease Outbreaks
Electrophoresis, Gel, Pulsed-Field
Enterobacteriaceae - drug effects - enzymology - genetics
Enterobacteriaceae Infections - epidemiology - microbiology
Finland - epidemiology
Hospitals, Pediatric - statistics & numerical data
Humans
beta-Lactamases - biosynthesis
Abstract
Four different extended-spectrum ß -lactamase (ESBL)-producing bacteria from a pediatric surgery ward were studied. The presence of TEM-, SHV-, and CTX-M-type ß -lactamases was analyzed and the relatedness of the isolates studied with a repetitive PCR system (DiversiLab) and pulsed-fi eld gel electrophoresis (PFGE). Molecular analysis showed that a clonal dissemination of CTX-M-15-producing Escherichia coli and Enterobacter cloacae had occurred.
PubMed ID
24303912 View in PubMed
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86 records – page 1 of 9.