Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies

doi:10.1097/PCC.0000000000000156

Review

. 2014 Sep;15(7):660-666.

doi: 10.1097/PCC.0000000000000156.

Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies

Affiliations

¹ Division of Critical Care Medicine, Department of Anesthesia and Critical Care, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
² Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
³ Kids Critical Care Research, Children's Hospital at Westmead, Sydney, Australia.
⁴ Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁵ Pediatric Intensive Care Unit and Research Center, Sainte-Justine Hospital, Montreal, Canada.
⁶ Division of Critical Care, Department of Pediatrics, University of British Columbia, Canada.
⁷ Departments of Surgery and Critical Care Medicine, St. Michael's Hospital, University of Toronto, Canada.
⁸ Division of Pediatric Critical Care Medicine, Penn State Hershey Children's Hospital, Penn State University College of Medicine, Hershey, PA, USA.

^# Contributed equally.

PMID: 24751790
PMCID: PMC4156527
DOI: 10.1097/PCC.0000000000000156

Review

Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies

Scott L Weiss et al. Pediatr Crit Care Med. 2014 Sep.

. 2014 Sep;15(7):660-666.

doi: 10.1097/PCC.0000000000000156.

Authors

Affiliations

¹ Division of Critical Care Medicine, Department of Anesthesia and Critical Care, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
² Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
³ Kids Critical Care Research, Children's Hospital at Westmead, Sydney, Australia.
⁴ Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁵ Pediatric Intensive Care Unit and Research Center, Sainte-Justine Hospital, Montreal, Canada.
⁶ Division of Critical Care, Department of Pediatrics, University of British Columbia, Canada.
⁷ Departments of Surgery and Critical Care Medicine, St. Michael's Hospital, University of Toronto, Canada.
⁸ Division of Pediatric Critical Care Medicine, Penn State Hershey Children's Hospital, Penn State University College of Medicine, Hershey, PA, USA.

^# Contributed equally.

PMID: 24751790
PMCID: PMC4156527
DOI: 10.1097/PCC.0000000000000156

Abstract

Objective: The point prevalence methodology is a valuable epidemiological study design that can optimize patient enrollment, prospectively gather individual-level data, and measure practice variability across a large number of geographic regions and healthcare settings. The objective of this article is to review the design, implementation, and analysis of recent point prevalence studies investigating the global epidemiology of pediatric critical illness.

Data sources: Literature review and primary datasets.

Study selection: Multicenter, international point prevalence studies performed in PICUs since 2007.

Data extraction: Study topic, number of sites, number of study days, patients screened, prevalence of disease, use of specified therapies, and outcomes.

Data synthesis: Since 2007, five-point prevalence studies have been performed on acute lung injury, neurologic disease, thromboprophylaxis, fluid resuscitation, and sepsis in PICUs. These studies were performed in 59-120 sites in 7-28 countries. All studies accounted for seasonal variation in pediatric disease by collecting data over multiple study days. Studies screened up to 6,317 patients and reported data on prevalence and therapeutic variability. Three studies also reported short-term outcomes, a valuable but atypical data element in point prevalence studies. Using these five studies as examples, the advantages and disadvantages and approach to designing, implementing, and analyzing point prevalence studies are reviewed.

Conclusions: Point prevalence studies in pediatric critical care can efficiently provide valuable insight on the global epidemiology of disease and practice patterns for critically ill children.

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References

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[1] Martin G. Epidemiology studies in critical care. Crit Care. 2006;10(2):136. - PMC - PubMed

[2] Martin G. Epidemiology studies in critical care. Crit Care. 2006;10(2):136. - PMC - PubMed

[3] Willson DF, Dean JM, Newth C, et al. Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatr Crit Care Med. 2006;7(4):301–307. - PubMed

[4] Willson DF, Dean JM, Newth C, et al. Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatr Crit Care Med. 2006;7(4):301–307. - PubMed

[5] Randolph AG, Gonzales CA, Cortellini L, et al. Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr. 2004;144(6):792–798. - PubMed

[6] Randolph AG, Gonzales CA, Cortellini L, et al. Growth of pediatric intensive care units in the United States from 1995 to 2001. J Pediatr. 2004;144(6):792–798. - PubMed

[7] Odetola FO, Clark SJ, Freed GL, et al. A national survey of pediatric critical care resources in the United States. Pediatrics. 2005;115(4):e382–386. - PubMed

[8] Odetola FO, Clark SJ, Freed GL, et al. A national survey of pediatric critical care resources in the United States. Pediatrics. 2005;115(4):e382–386. - PubMed

[9] Haut ER, Pronovost PJ, Schneider EB. Limitations of administrative databases. JAMA. 2012;307(24):2589. author reply 2589-2590. - PubMed

[10] Haut ER, Pronovost PJ, Schneider EB. Limitations of administrative databases. JAMA. 2012;307(24):2589. author reply 2589-2590. - PubMed

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Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies

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Understanding the global epidemiology of pediatric critical illness: the power, pitfalls, and practicalities of point prevalence studies

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