660: FACTORS ASSOCIATED WITH RECURRENT THROMBOSIS IN PEDIATRIC PATIENTS RECEIVING ECMO THERAPY

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.

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Using an App to monitor postoperative pain at home in pediatric patients

Journal of Child Health Care ◽

10.1177/1367493520919313 ◽

2021 ◽

pp. 136749352091931

Author(s):

Emanuela Tiozzo ◽

Valentina Biagioli ◽

Matilde Brancaccio ◽

Riccardo Ricci ◽

Anna Marchetti ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Health Professionals ◽

Pediatric Patients ◽

Pain Scale ◽

Factors Associated ◽

Prospective Comparative Study ◽

Paper And Pencil ◽

The Impact ◽

At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

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Prevalence and Contributing Factors Associated With Postoperative Pain in Pediatric Patients: A Cross-Sectional Follow-up Study

Perioperative Care and Operating Room Management ◽

10.1016/j.pcorm.2021.100159 ◽

2021 ◽

Vol 23 ◽

pp. 100159

Author(s):

Zemenay Ayinie Mekonnen ◽

Debas Yaregal Melesse ◽

Habitamu Getinet Kassahun ◽

Tesera Dereje Flatie ◽

Misganaw Mengie Workie ◽

...

Keyword(s):

Postoperative Pain ◽

Pediatric Patients ◽

Contributing Factors ◽

Cross Sectional ◽

Factors Associated ◽

Follow Up Study

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Risk Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery

JBJS Reviews ◽

10.2106/jbjs.rvw.19.00163 ◽

2020 ◽

Vol 8 (3) ◽

pp. e0163

Author(s):

Hiroko Matsumoto ◽

Matthew E. Simhon ◽

Megan L. Campbell ◽

Michael G. Vitale ◽

Elaine L. Larson

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Spinal Deformity ◽

Pediatric Patients ◽

Site Infection ◽

Factors Associated ◽

Spinal Deformity Surgery

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Sociodemographic Factors Associated With Decreased Compliance to Prescribed Rehabilitation After Surgical Treatment of Knee Injuries in Pediatric Patients

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211052021 ◽

2021 ◽

Vol 9 (11) ◽

pp. 232596712110520

Author(s):

Allan K. Metz ◽

Tami Hart-Johnson ◽

R. Alexander Blackwood ◽

Eileen A. Crawford

Keyword(s):

Sample Size ◽

Pediatric Patients ◽

Compliance Rate ◽

Knee Injuries ◽

Sociodemographic Factors ◽

Single Parent ◽

Knee Surgery ◽

Activity Level ◽

Factors Associated ◽

Rehabilitation Clinic

Background: Rehabilitation is an important component of care in postsurgical knee patients, especially as it pertains to return to preinjury activity level. Despite the established significance of rehabilitation in improving outcomes after certain surgical procedures, there is a lack of investigation into compliance rates and factors that affect compliance in pediatric patients. Purpose/Hypothesis: The purpose of this study was to evaluate sociodemographic factors associated with noncompliance in pediatric patients after knee surgery to characterize health disparities in this population. Our hypothesis was that certain sociodemographic factors would be associated with decreased compliance. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective review of medical records was used to gather data on compliance rate, demographics, and socioeconomic factors for pediatric patients undergoing rehabilitation after knee surgery. Compliance rate was determined by counting the total scheduled appointments, cancellations, and no-shows (defined as visits for which patients did not show up and did not provide notification of cancellation). Various types of knee injuries were included in this study. Data were evaluated using bivariate analyses in addition to hierarchical linear and binary logistic regression to assess for associations between sociodemographic factors and compliance rate. Results: Our total sample size was 186 patients. When compared with patients from non–single-parent households, patients from single-parent households were found to have a lower rate of physical therapy compliance (72.2% vs 80.1%; P < .001), were less likely to reach the 85% compliance threshold (9.1% vs 42.4%; P < .001), and had an increased amount of cancellations and no-shows (16.7 vs 11.7 visits; P = .02). Although a small sample size, Hispanic/Latino patients were shown to have a lower achievement of the 85% compliance threshold compared with non-Hispanic/Latino patients (0% vs 38.2%; P = .04). Increased distance from the rehabilitation clinic was associated with lower achievement of the 85% compliance threshold ( P = .033). Conclusion: Overall, there were several significant demographic and socioeconomic variables associated with rehabilitation compliance, specifically single-parent status, distance to rehabilitation clinic, and ethnicity. These results suggest potential predictors of decreased compliance that warrant prospective investigation.

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Factors Associated with Acute Toxicity in Pediatric Patients Treated with Proton Radiotherapy: A Report from the Pediatric Proton Consortium Registry

Practical Radiation Oncology ◽

10.1016/j.prro.2021.10.011 ◽

2021 ◽

Author(s):

William G. Breen ◽

Arnold C. Paulino ◽

William F. Hartsell ◽

Victor S. Mangona ◽

Stephanie M. Perkins ◽

...

Keyword(s):

Acute Toxicity ◽

Pediatric Patients ◽

Proton Radiotherapy ◽

Factors Associated

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#31: Risk Factors Associated with Mortality due to Multidrug-Resistant Organisms in Pediatric Oncology Patients with Febrile Neutropenia

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa170.048 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

pp. S15-S16

Author(s):

Miguel A Minero ◽

Asia Castro ◽

Martha Avilés-Robles

Keyword(s):

Risk Factors ◽

Septic Shock ◽

Febrile Neutropenia ◽

Pediatric Oncology ◽

Pediatric Patients ◽

Bloodstream Infections ◽

Oncology Patients ◽

Factors Associated ◽

Patients With Cancer ◽

The Impact

Abstract Background Infectious processes are frequent complications presented in pediatric patients with cancer. Currently, the indiscriminate use of antibiotics induces resistance to available treatments, creating the emergence of multi-drug-resistant organisms (MDROs). Due to the impact in morbidity and mortality secondary to MDRO infection, we aimed to identify risk factors associated with mortality in infections due to MDROs in pediatric patients with cancer. Methods Case–control study nested in a prospective cohort of pediatric oncology patients with febrile neutropenia (FN) at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from March 2015 to September 2017. MDRO was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Patients with FN episodes who died from an infection due to MDROs were defined as cases and patients with FN episodes of an infection due to MDROs who did not die were defined as controls. Mucositis, septic shock, PICU stay, and bacterial prophylaxis (Trimethoprim/Sulfamethoxazole) were compared between groups. Descriptive statistics was performed and Pearson χ 2 or Student’s t-test were used to compare risk factors between groups. Results A total of 929 FN episodes were documented, 44.4% episodes occurred in male patients, mean age was 7.9 years, with the population under 5 years being the most represented (68.2%). The most frequent diagnosis was acute lymphoblastic leukemia in 75% followed by rhabdomyosarcoma in 10.5% and acute myeloid leukemia in 9.6%. Prophylaxis (trimethoprim/sulfamethoxazole) was used in 86%, mucositis was present in 9.2% of episodes. 12.1% had septic shock and 4.7% were admitted to PICU. In 148 FN episodes (15.9%) a microorganism was identified, of these 50 (33.7%) were due to an MDROs. Urinary tract infection was the most frequent site (49%), followed by bloodstream infections (47%). K. pneumoniae was the most frequent MDRO in 22.8%, followed by E. coli in 19.2% and P. aeruginosa in 14%. Septic shock was presented in 26% of MDROs infections. Overall mortality was 1.94% and only 0.86% (8) were secondary to MDROs. Of patients with MDRO isolated mortality was 30% (15/50). Mortality associated with bloodstream infection due to MDROs was 25% compared with other source of MDROs infections (3%) (P = 0.01). Septic shock was present in 40% of patients with death due to MDROs infection (P = 0.001). Conclusions In our population of children with FN episodes who had an isolated microorganism, infection due to MDROs are high (33.7%) and MDROs infection-directed mortality was as high as 30%. Bloodstream infections and septic shock were risk factors associated with mortality due to MDROs.

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