Cost of Hospitalization in Children Who Develop Perioperative Respiratory Event

NCT02036021 | Completed DMC

• 1 other identifier: cost904
• Study Type: observational
• Target: 1,004
• Locations: 1 country
• Sites: 1

Brief Summary

Mortality related with cardiac arrest in anesthetized children has diminished over several decades from 2.9 per 10000 anesthesias in 1961 to 0.21 per 10000 anesthesias in 2007.(1) Even though the mortality rate related to pediatric anesthesia is much lower than before, respiratory complications related with peri-operative cardiac arrest are as high as 27% according to the Pediatric Peri-operative Cardiac Arrest (POCA) Registry.(2).Therefore, peri-operative respiratory event (PRE) in pediatric anesthesia such as laryngospasm, stridor, bronchospasm, desaturation and reintubation are crucial. Stridor and reintubation occur after the children are extubated, mostly in the PACU period. Laryngospasm, stridor, bronchospasm and wheezing can lead to desaturation and the need for reintubation. Those PRE, especially peri-operative desaturation, can prolong PACU stay especially if PRE develops in the PACU.(8,9) PRE occurring during the intraoperative period can also prolong PACU stay if children are observed at PACU and not transferred directly to the intensive care unit (ICU). Some children require oxygen therapy in the PACU and continue at the ward. Some need endotracheal tube intubation with spontaneous breathing or are placed on mechanical ventilator. Thai AIMS (10) reported that desaturation at PACU was associated with re-intubation, prolonged mechanical ventilation and unplanned ICU admission. Oxygen supplement need, prolonged mechanical ventilation or unplanned ICU admission can produce extra days of hospitalization or increase the cost of hospitalization from extra-cost payment eg; oxygen therapy, mechanical ventilator, cost of ICU stayed. Furthermore, the short-term sequelae regarding cost of hospitalization of children who develop PRE has never been evaluated or compared with the cost in children who do not develop PRE. Higher cost of hospitalization after occurrence of PRE in anesthetized children will have an impact to the hospital policy maker. Minimizing PRE can save on the cost of hospital care to the public hospital or other health sectors. Therefore, we would like to compare days of hospitalization and cost differences of hospitalization between children who develop PRE and children who do not develop PRE at a tertiary care hospital in southern Thailand

Conditions

Hospitalization; Cost of Illness

Keywords

pediatric anesthesia; perioperative respiratory events; days of hospitalization; cost of hospitalization

Outcome Measures

Primary Outcomes (1)

• cost of hospitalization

  November 2012-January 2014

  15 months

Secondary Outcomes (1)

• days of hospitalization

  15 months

Study Arms (1)

PRE/non-PRE

children who develop or did not perioperative respiratory events between November 2012 and December 2013

Eligibility Criteria

• Age: 1 Day - 14 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Children aged \< 15 years who received general anesthesia in Songklanagarind Hospital between November 2012 and December 2013

You may qualify if:

• Children aged \< 15 years who received general anesthesia and developed PRE or who had no PRE in Songklanagarind Hospital between November 2012 and December 2013

You may not qualify if:

• ASA classification 4 or 5
• Preoperative SpO2 \< 95% at room air
• Required preoperative endotracheal tube intubation (ETT) or mechanical ventilation
• Had congenital cyanotic heart disease

Sponsors & Collaborators

• Prince of Songkla University: lead
• The Royal Golden Jubilee PhD funding of Thailand: collaborator

Study Sites (1)

Faculty of Medicine, Prince of Songkla University

Hat Yai, Changwat Songkhla, 90110, Thailand

Location

Related Publications (1)

• Oofuvong M, Geater AF, Chongsuvivatwong V, Chanchayanon T, Sriyanaluk B, Suwanrat B, Nuanjun K. Does perioperative respiratory event increase length of hospital stay and hospital cost in pediatric ambulatory surgery? PLoS One. 2021 May 13;16(5):e0251433. doi: 10.1371/journal.pone.0251433. eCollection 2021.

  PMID: 33984031 DERIVED

Study Officials

• Maliwan Oofuvong, MD

  Prince of Songkla University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Department of Anesthesiology

Study Record Dates

• First Submitted: January 11, 2014
• First Posted: January 14, 2014
• Study Start: November 1, 2012
• Primary Completion: January 1, 2014
• Study Completion: January 1, 2014
• Last Updated: October 31, 2014

Record last verified: 2014-10

Locations

TH (1)