Pediatric anesthesia & critical care
Diagnostic Uncertainty Among Critically Ill Children Admitted to the PICU: A Multicenter Study
Authors' conclusion
Diagnostic uncertainty at PICU admission was common and was associated with off hours admission, severe illness, atypical presentation, diagnostic discordance between clinicians, and a neurologic primary diagnosis.
Study context
- Population
- Children 0–18 years nonelectively admitted to 4 academic tertiary-referral PICUsrandomly selected
- Participants
- 882 children
- Outcome
- Prevalence of diagnostic uncertainty in PICU admission notes
- Follow-up
- PICU admission
Methodological detailsmulticentre, structured medical record review, generalized linear mixed models
- Multicentre
- Structured medical record review
- Generalized linear mixed models
Main finding
As reported in the abstract
Diagnostic uncertainty in PICU admission notes
PICU admission notes indicating diagnostic uncertainty
228 of 882 patients
25.9%
Observational data: associations, not effects.
Further findings
Factors associated with diagnostic uncertainty at PICU admission (multivariable analysis)
| OR | P value | |
|---|---|---|
| Off hours admissionMultivariable analysis | 1.52 | P = 0.037 |
| Greater severity of illnessMultivariable analysis | 1.04 | P = 0.025 |
| Atypical presentationMultivariable analysis | 2.14 | P = 0.046 |
| Diagnostic discordance at admission between attending intensivists and resident physicians/advanced practice providersMultivariable analysis | 3.62 | P < 0.001 |
| Neurologic primary diagnosisMultivariable analysis | 1.87 | P = 0.03 |
| Older patientsLess likely to have diagnostic uncertainty · multivariable analysis | 0.96 | P = 0.014 |
| Respiratory primary diagnosisLess likely to have diagnostic uncertainty · multivariable analysis | 0.58 | P = 0.009 |
| Trauma primary diagnosisLess likely to have diagnostic uncertainty · multivariable analysis | 0.08 | P < 0.001 |
Remaining diagnostic uncertainty · hospital discharge
- Patients with uncertainty decreased over time; remaining diagnostic uncertainty at hospital discharge
- 58 (6.6%)
Factors associated with diagnostic uncertainty at PICU admission (multivariable analysis)
- No significant associations between diagnostic uncertainty and attending intensivists' characteristics
Original publication
Diagnostic Uncertainty Among Critically Ill Children Admitted to the PICU: A Multicenter Study. Crit Care Med. Published 25 November 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →