The value of failure to rescue in determining hospital quality for pediatric trauma.

摘要: BACKGROUND In adult trauma patients, high- and low-mortality hospitals have similar rates of major complications but differ based on failure to rescue (mortality following a complication), which has become marker hospital quality. The aim this study is examine whether also an appropriate quality indicator in pediatric trauma. METHODS Children younger than 15 years were identified the 2007 2014 National Trauma Databank research data sets. Hospitals classified as high, average or low mortality risk-adjusted observed-to-expected in-hospital ratios using modified Mortality Probability Model. Regression modeling was used explore impact ranking incidence rescue. RESULTS Of 125,057 children, 31,600 treated at outlier hospitals, 7,014 high-mortality hospitals. Low-mortality had lower rate compared with (0.5% [low] vs. 0.8% [high]; adjusted odds ratio [OR], 0.71; 95% confidence interval [CI], 0.61-0.83; p < 0.01) failure-to-rescue (17.6% 24.1% OR, 0.53 [high; CI 0.34-0.83; 0.01]). When patients who died within 48 hours excluded, complication (OR, 0.81; CI, 0.68, 0.96; = 0.02), There no correlation between verification level status model. CONCLUSION For more strongly associated Thus, does not appear be key driver population it population. LEVEL OF EVIDENCE Prognostic epidemiological, III.