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    Global PARITY: Study Design for a Multi-Centered, International Point Prevalence Study to Estimate the Burden of Pediatric Acute Critical Illness in Resource-Limited Settings.

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    Author
    Abbas, Qalab
    Holloway, Adrian
    Caporal, Paula
    López-Barón, Eliana
    Agulnik, Asya
    Remy, Kenneth E
    Appiah, John A
    Attebery, Jonah
    Fink, Ericka L
    Lee, Jan Hau
    Hooli, Shubhada
    Kissoon, Niranjan
    Miller, Erika
    Murthy, Srinivas
    Muttalib, Fiona
    Nielsen, Katie
    Puerto-Torres, Maria
    Rodrigues, Karla
    Sakaan, Firas
    Rodrigues, Adriana Teixeira
    Tabor, Erica A
    von Saint Andre-von Arnim, Amelie
    Wiens, Matthew O
    Blackwelder, William
    He, David
    Kortz, Teresa B
    Bhutta, Adnan T
    Show allShow less

    Date
    2022-01-28
    Journal
    Frontiers in Pediatrics
    Publisher
    Frontiers Media S.A.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.3389/fped.2021.793326
    Abstract
    BACKGROUND: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally. METHODS: We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites. DISCUSSION: This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes.
    Rights/Terms
    Copyright © 2022 Abbas, Holloway, Caporal, López-Barón, Agulnik, Remy, Appiah, Attebery, Fink, Lee, Hooli, Kissoon, Miller, Murthy, Muttalib, Nielsen, Puerto-Torres, Rodrigues, Sakaan, Rodrigues, Tabor, von Saint Andre-von Arnim, Wiens, Blackwelder, He, Kortz and Bhutta.
    Keyword
    acute pediatric care
    critical care
    low resource setting
    low-and lower-middle-income countries
    outcome
    pediatric critical illness
    resource utilization
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17993
    ae974a485f413a2113503eed53cd6c53
    10.3389/fped.2021.793326
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