The Journal of Pediatrics
Volume 152, Issue 5 , Pages 629-635.e2 , May 2008

Variation in Inpatient Resource Utilization and Management of Apparent Life-Threatening Events

  • Joel S. Tieder, MD, MPH

      Affiliations

    • From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
    • Children's Hospital and Regional Medical Center, Seattle, WA
    • Corresponding Author InformationReprint requests: Joel S. Tieder, MD, MPH, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Mail Stop T-1201, Seattle, WA 98105.
    • ,
  • Charles A. Cowan, MD

      Affiliations

    • From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
    • Children's Hospital and Regional Medical Center, Seattle, WA
    • ,
  • Michelle M. Garrison, PHD

      Affiliations

    • From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
    • Child Health Institute, Seattle, WA.
    • ,
  • Dimitri A. Christakis, MPH

      Affiliations

    • From the Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
    • Children's Hospital and Regional Medical Center, Seattle, WA
    • Child Health Institute, Seattle, WA.

Received 5 March 2007 ,Revised 11 July 2007 ,Accepted 12 November 2007.

References 

  1. National Institutes of Health. Consensus Development Conference on Infantile Apnea and Home Monitoring, September 29 to October 1, 1986: consensus statement. Pediatrics. 1987;79:292–299
  2. McGovern MC, Smith MB. Causes of apparent life-threatening events in infants: a systematic review. Arch Dis Child. 2004;89:1043–1048
  3. Davies F, Gupta R. Apparent life-threatening events in infants presenting to a pediatric emergency department. Emerg Med J. 2002;19:11–16
  4. Kiechl-Kohlendorfer U, Hof D, Pupp Peglow UP, Traweger-Ravanelli B, Kiechl S. Epidemiology of apparent life-threatening events. Arch Dis Child. 2005;90:297–300
  5. Davis N, Bossung-Sweeney L, Peterson DR. Epidemiological comparisons of sudden infant death syndrome with infant apnoea. Aust Paediatr J. 1986;(Suppl 1):29–32
  6. Wennergren G, Milerad J, Lagercrantz H, Karlberg P, Svenningsen NW, Sedin G, et al. The epidemiology of sudden infant death syndrome and attacks of lifelessness in Sweden. Acta Paediatr Scand. 1987;76:898–906
  7. Kahn A European Society for the Study and Prevention of Infant Death. Recommended clinical evaluation of infants with an apparent life-threatening event (Consensus document of the European Society for the Study and Prevention of Infant Death, 2003). Eur J Pediatr. 2004;163:108–115
  8. Brand DA, Altman RL, Purtill K, Edwards KS. Yield of diagnostic testing in infants who have had an apparent life-threatening event. Pediatrics. 2005;115:885–893
  9. Claudius I, Keens T. Do all infants with apparent life-threatening events need to be admitted?. Pediatrics. 2007;119:679–683
  10. Gray C, Davies F, Molyneux E. Apparent life-threatening events presenting to a paediatric emergency department. Pediatr Emerg Care. 1999;15:195–199
  11. Tal Y, Tirosh E, Even L, Jaffe M. A comparison of the yield of a 24 h versus 72 h hospital evaluation in infants with apparent life-threatening events. Eur J Paediatr. 1999;158:954
  12. Bergman DA. Evidence-based guidelines and critical pathways for quality improvement. Pediatrics. 1999;103(1 Supp E):225–232
  13. Grimshaw J, Russell IT. Effects of clinical guidelines on medical practice: a systematic review of rigorous evaluation. Lancet. 1993;342:1317–1322
  14. Newman K, Ponsky T, Kittle K, Dyk L, Throop C, Gieseker K, et al. Appendicitis 2000: variability in practice, outcomes, and resource utilization at thirty pediatric hospitals. J Pediatr Surg. 2003;38:372–379
  15. Kittle K, Currier K, Dyk L, Newman K. Using a pediatric database to drive quality improvement. Semin Pediatr Surg. 2002;11:60–63
  16. Christakis DA, Cowan CA, Garrison MM, Molteni R, Marcuse E, Zerr DM. Variation in inpatient diagnostic testing and management of bronchiolitis. Pediatrics. 2005;115:878–884
  17. Ponsky TA, Huang ZJ, Kittle K, Eichelberger MR, Gilbert JC, Brody F, et al. Hospital- and patient-level characteristics and the risk of appendiceal rupture and negative appendectomy in children. Jama. 2004;292:1977–1982
  18. Donner A, Donald A. Analysis of data arising from a stratified design with the cluster as unit of randomization. Stat Med. 1987;6:43–52
  19. Neuhaus JM, Kalbfleisch JD, Hauck WW. A comparison of cluster-specific and population-averaged approaches for analyzing correlated binary data. Int Stat Rev. 1991;59:25–35
  20. Nelson SP, Chen EH, Syniar GM, Christoffel KK. Prevalence of symptoms of gastroesophageal reflux during infancy: a pediatric practice-based survey (Pediatric Practice Research Group). Arch Pediatr Adolesc Med. 1997;151:569–572
  21. Tirosh E, Kessel A, Jaffe M, Cohen A. Outcome of idiopathic apparent life-threatening events: infant and mother perspectives. Pediatr Pulmonol. 1999;28:47–52
  22. Arad-Cohen N, Cohen A, Tirosh E. The relationship between gastroesophageal reflux and apnea in infants. J Pediatr. 2000;137:321–326
  23. Rudolph CD, Mazur LJ, Liptak GS, Baker RD, Boyle JT, Coletti RB, et al. Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2001;32(Suppl 2):S1–S31
  24. Tsukada K, Kosuge N, Hosokawa M, Umezu R, Murata M. Etiology of 19 infants with apparent life threatening events: relationship between apnea and oesophageal dysfunction. Acta Paediatr Jpn. 1993;35:306–310
  25. Jolley SG, Halpern LM, Tunell WP, Johnson DG, Sterling CE. The risk of sudden infant death from gastroesophageal reflux. J Pediatr Surg. 1991;26:691–696
  26. Veereman-Wauters G, Bochner A, Van Caillie-Bertrand M. Gastroesophageal reflux in infants with a history of near-miss sudden infant death. J Pediatr Gastroenterol Nutr. 1991;12:319–323
  27. Di Fiore JM, Arko M, Whitehouse M, Kimball A, Martin RJ. Apnea is not prolonged by acid gastroesophageal reflux in preterm infants. Pediatrics. 2005;116:1059–1063
  28. Peter CS, Sprodowski N, Bohnhorst B, Silny J, Poets CF. Gastroesophageal reflux and apnea of prematurity: no temporal relationship. Pediatrics. 2002;109:8–11
  29. Green M, Solnit AJ. Reaction to the threatened loss of a child: a vulnerable child syndrome (Pediatric management of the dying child, part III). Pediatrics. 1964;34:58–66

PII: S0022-3476(07)01068-2

doi: 10.1016/j.jpeds.2007.11.024

The Journal of Pediatrics
Volume 152, Issue 5 , Pages 629-635.e2 , May 2008

Article Tools

* Image Usage & Resolution