Semiautomated electronic medical record based system for monitoring delayed adverse events in pediatric endoscopy and sedation. J Pediatr Gastroenterol Nutr 2024 Jul;79(1):154-160
Date
05/21/2024Pubmed ID
38769769DOI
10.1002/jpn3.12254Scopus ID
2-s2.0-85193501737 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVE: To develop a semiautomated electronic medical record (EMR) system to track pediatric endoscopic procedural adverse event (AE) at a tertiary referral children's hospital.
METHODS: We developed an automated EMR based query for postprocedure AEs. Main outcome measurements within 30 days of procedure: return to emergency department, return to surgery, unplanned admissions and admissions with longer than intended stays. Events were graded using a recently described classification system for postendoscopy events and tracked for a 36-month period, from January 2017 to December 2019.
RESULTS: Development of a semi-automated system was successful in comprehensive identification of endoscopy and sedation related AE. A total of 193 AEs (2%) were identified in all three categories. Seventy cases (0.7%) were noted to be a direct result of an endoscopic procedure. Of these cases, 31 (44%) were noted to be Grade 3, 5 cases (7%) Grade 4, and no Grade 5 AE occured. Higher rates of AE were observed after therapeutic procedures versus diagnostic (2.6% vs. 0.3%, p = <0.00001). AEs related to sedation occurred in 0.5% of procedures with the majority (84%) reported in patients with American Society of Anesthesia classification of 3 or greater.
CONCLUSIONS: Diagnostic endoscopy remains a safe procedure and risk of both endoscopy and sedation related AE are low. Therapeutic procedures carry a higher risk but are still overwhelmingly safe. Institutional investment in this EMR based system allowed for sustainability and comprehensive tracking of endoscopy related AE.
Author List
Wong J, Abazi T, Thielke R, Lerner DAuthor
Diana Lerner MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentChild
Child, Preschool
Electronic Health Records
Endoscopy, Gastrointestinal
Female
Hospitals, Pediatric
Humans
Infant
Male
Retrospective Studies
