{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:54:59Z","timestamp":1783432499037,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:00:00Z","timestamp":1544400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"ESA (European Society of Anaesthesiology)","award":["NCT01878760"],"award-info":[{"award-number":["NCT01878760"]}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2019,3]]},"abstract":"Summary<\/jats:title>\n \n The anaesthesia practice in children observational trial of 31,127 patients in 261 European hospitals revealed a high (5.2%) incidence of severe critical events in the peri\u2010operative period and wide variability in practice. A sub\u2010analysis of the\n UK<\/jats:styled-content>\n data was undertaken to investigate differences compared with the non\u2010\n UK<\/jats:styled-content>\n cohort in the incidence and nature of peri\u2010operative severe critical events and to attempt to identify areas for quality improvement. In the\n UK<\/jats:styled-content>\n cohort of 7040 paediatric patients from 43 hospitals, the overall incidence of peri\u2010operative severe critical events was lower than in the non\u2010\n UK<\/jats:styled-content>\n cohort (3.3%, 95%\n CI<\/jats:styled-content>\n : 2.9\u20133.8 vs. 5.8%, 95%\n CI<\/jats:styled-content>\n : 5.5\u20136.1,\n RR<\/jats:styled-content>\n 0.57, p\u00a0<\u00a00.001). There was a lower rate of bronchospasm (\n RR<\/jats:styled-content>\n 0.22, 95%\n CI<\/jats:styled-content>\n : 0.14\u20130.33; p\u00a0<\u00a00.001), stridor (\n RR<\/jats:styled-content>\n 0.42, 95%\n CI<\/jats:styled-content>\n : 0.28\u20130.65; p\u00a0<\u00a00.001) and cardiovascular instability (\n RR<\/jats:styled-content>\n 0.69, 95%\n CI<\/jats:styled-content>\n : 0.55\u20130.86; p\u00a0=\u00a00.001) than in the non\u2010\n UK<\/jats:styled-content>\n cohort. The proportion of sicker patients where less experienced teams were managing care was lower in the\n UK<\/jats:styled-content>\n than in the non\u2010\n UK<\/jats:styled-content>\n cohort (10.4% vs. 20.4% of the\n ASA<\/jats:styled-content>\n physical status 3 and 9% vs. 12.9% of the\n ASA<\/jats:styled-content>\n physical status 4 patients). Differences in work\u2010load between centres did not affect the incidence and outcomes of severe critical events when stratified for age and\n ASA<\/jats:styled-content>\n physical status. The lower incidence of cardiovascular and respiratory complications could be partly attributed to more experienced dedicated paediatric anaesthesia providers managing the higher risk patients in the\n UK<\/jats:styled-content>\n . Areas for quality improvement include: standardisation of serious critical event definitions; increased reporting; development of evidence\u2010based protocols for management of serious critical events; development and rational use of paediatric peri\u2010operative risk assessment scores; implementation of current best practice in provision of competent paediatric anaesthesia services in Europe; development of specific training in the management of severe peri\u2010operative critical events; and implementation of systems for ensuring maintenance of skills.\n <\/jats:p>","DOI":"10.1111\/anae.14520","type":"journal-article","created":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T04:22:44Z","timestamp":1544415764000},"page":"300-311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Incidence of severe critical events in paediatric anaesthesia in the United Kingdom: secondary analysis of the anaesthesia practice in children observational trial (APRICOT study)"],"prefix":"10.1111","volume":"74","author":[{"given":"T.","family":"Engelhardt","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Royal Aberdeen Children's Hospital Aberdeen UK"},{"name":"Institute of Education for Medical and Dental Sciences School of Medicine, Medical Sciences and Nutrition University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Ayansina","sequence":"additional","affiliation":[{"name":"Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. T.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Hospital for Children Glasgow Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Oshan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Royal Manchester Children's Hospital Manchester University NHS Foundation Trust Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Designated Paediatric Anaesthetist Dumfries and Galloway Royal Infirmary Dumfries, Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. S.","family":"Morton","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Pain Management University of Glasgow Glasgow, Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the APRICOT Group of the European Society of Anaesthesiology Clinical Trial Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30117-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12753"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1927.10502953"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01167.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318213be52"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12207"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000040"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12862"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001059"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex072"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199701000-00060"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61193-2"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq398"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002208"},{"key":"e_1_2_6_17_1","volume-title":"Guidelines for the provision of Paediatric Anaesthetic services 2017","author":"RCOA","year":"2017"},{"key":"e_1_2_6_18_1","volume-title":"Anaesthesia clinical services accreditation standards","author":"RCOA","year":"2018"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-015-0492-y"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12623"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.08.004"},{"key":"e_1_2_6_22_1","volume-title":"Raising the Standards: a compendium of audit recipes for continuous quality improvement in anaesthesia","author":"RCOA","year":"2012"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13224"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.12.014"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.01.005"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000186"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-310104"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.14520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.14520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.14520","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.14520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T19:54:18Z","timestamp":1761681258000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.14520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,10]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1111\/anae.14520"],"URL":"https:\/\/doi.org\/10.1111\/anae.14520","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,10]]},"assertion":[{"value":"2018-10-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}