Hospital-acquired infections are the leading cause of preventable mortality in pediatric patients, according to an analysis of data from hospitals in 19 states.
Out of 5 million pediatric patient records from the period 2006–2008, there were 25,367 events identified, and of those, 1,465 potentially preventable inpatient deaths, according to HealthGrades, the independent health care ratings organization that conducted the review.
Seventy percent of the deaths were associated with hospital-acquired infections, the Golden, Colo.–based company concluded.
Overall, 1 in 208 pediatric patients experienced a potentially preventable event.
The organization cautioned that while this may seem like a low rate, it is calculated only for 19 states and only for eight safety measures developed by the Agency for Healthcare Research and Quality.
The eight indicators were accidental puncture or laceration; pressure ulcer; avoidance of collapsed lung; postoperative hemorrhage or hematoma; postoperative respiratory failure; postoperative sepsis; postoperative wound dehiscence; and central venous catheter-related infections.
Four incidents that occurred with the most frequency per 1,000 patients were postoperative sepsis (at a rate of 24 per 1,000), postoperative respiratory failure (18), pressure ulcers (3), and central venous catheter-related infections (2).
There was improvement in four of the measures over the study period: selected infections due to medical care, postop hemorrhage or hematoma, postop respiratory failure, and postop wound dehiscence.
But four indicators worsened: accidental puncture, pressure ulcer, iatrogenic pneumothorax, and postop sepsis.
HealthGrades said it decided to undertake its first-ever review of pediatric safety because families and health care providers might not be familiar with the magnitude of errors in the pediatric population.
There are more than 6 million pediatric hospitalizations each year, 40% of which come through the emergency department.
Pediatric hospitals and programs largely have been overlooked or excluded from quality improvement efforts, according to the company.
The states with the best-rated pediatric safety performance were California, Florida, Iowa, Oregon, Utah, and Wisconsin.
Wide variation in quality was noted among the 2,080 hospitals that reported data.
HealthGrades conferred patient safety awards on 97 hospitals that had rates that were statistically lower than those of the other facilities studied.
Children at those hospitals had a 29% lower risk of experiencing one or more of the events compared with patients at the other facilities.
A venture capital company, Vestar Capital Partners, recently agreed to purchase HealthGrades.