Hospitalization Clinical Trial
Official title:
Comparison of Cost of Hospitalization in Children After General Anesthesia With and Without Perioperative Respiratory Event at a Tertiary Care Hospital in Southern Thailand
Verified date | October 2014 |
Source | Prince of Songkla University |
Contact | n/a |
Is FDA regulated | No |
Health authority | Thailand: Ethical Committee |
Study type | Observational |
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
Status | Completed |
Enrollment | 1004 |
Est. completion date | January 2014 |
Est. primary completion date | January 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A to 14 Years |
Eligibility |
Inclusion Criteria: - 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 Exclusion Criteria: 1. ASA classification 4 or 5 2. Preoperative SpO2 < 95% at room air 3. Required preoperative endotracheal tube intubation (ETT) or mechanical ventilation 4. Had congenital cyanotic heart disease |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
Thailand | Faculty of Medicine, Prince of Songkla University | Hat Yai | Songkhla |
Lead Sponsor | Collaborator |
---|---|
Prince of Songkla University | The Royal Golden Jubilee PhD funding of Thailand |
Thailand,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | cost of hospitalization | November 2012-January 2014 | 15 months | Yes |
Secondary | days of hospitalization | November 2012-January 2014 | 15 months | Yes |
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