Background: Diagnostic errors are frequent and are known to cause adverse events (AEs). The scope of this problem in paediatrics has not been addressed.
Methods: While validating the Canadian Association of Paediatric Health Centres’ Paediatric Trigger Tool, all AEs detected were categorized by age group (4 groups: 0-28 days, 29-365 days,>1-5 yrs and >5- 18 yrs), contributory factors (eg: surgical, diagnostic), associated mortality, etc. Of the 591 charts reviewed, 89 patients (15.1%) had AEs. This paper analyzes these events.
Results: Diagnostic AEs (DAEs) occurred in 14 of 89 patients with AEs (15.7%) and 11.4% of all AEs (14/123) were diagnostic. DAEs were more common in children <1 year of age (8/298=2.7%) than in those >1 -18 years (6/ 293=2.0%). However DAEs accounted for more of the AEs in children >5 years vs <5 (3/16= 18.8% vs 11/107=10.3%). Of DAEs 50% were infections and 14.3% (2/14) of patients with DAEs died vs 2.7% (2/75) of those without DAEs. All deaths were in neonates.
| Age Group | # DAEs | Percent of AE patients w/DAE - % (n DAE/n All) | DAEs as Percent of All AEs % (n DAE/n All AE) |
| 0-28 days | 4 | 12.12 (4/33) | 5.36 (4/56) |
| 29-365 days | 4 | 19.05 (4/21) | 14.81 (4/27) |
| >1-5 years | 3 | 5.55 ( 3/54) | 12.5 (3/24) |
| >5 years | 3 | 16.66 (3/18) | 18.75 (3/16) |
Conclusion: DAEs are an important cause of morbidity in hospitalized children, with potentially severe consequences in neonates. Infections are more common DAEs in children than in adults. The visibility of DAEs as a significant patient safety concern in pediatrics must be heightened in order to understand, identify and prevent them in the future.
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