Journal article
Unexplained Deaths in a Children's Hospital: An Epidemiologic Assessment
The New England journal of medicine, v 313(4), pp 211-216
25 Jul 1985
PMID: 4010725
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Abstract During a nine-month period, July 1980 through March 1981, the mortality rate for patients on the cardiology ward of a children's hospital was 43.1 deaths per 10,000 patient-days, as compared with 11.0 deaths per 10,000 patient-days during the preceding 54 months. Twenty-five (76 per cent) of 33 infant deaths during this nine-month period occurred between midnight and 6:00 a.m., as compared with 1 of 10 infant deaths during a separate 27-month period (P<0.001). Although nearly all deaths occurred in patients with serious congenital heart disease, epidemic-period deaths were more likely to have an unexpected timing and a clinical pattern consistent with digoxin toxicity. In four patients, forensic and clinical digoxin measurements suggested that an intravenous overdose of digoxin had been administered shortly before death. Although a review of nursing schedules revealed a strong association (relative risk, 64.6) between infant deaths and the duty times of a particular nurse, the cause of the epidemic remains unclear. The study led to suggestions that the hospital strengthen central control over procedures for dispensing medicines and implement a system for monitoring the occurrence of deaths by time and place within the hospital. (N Engl J Med 1985; 313: 211-6.)
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Details
- Title
- Unexplained Deaths in a Children's Hospital
- Creators
- James W BuehlerLesbia F SmithEvelyn M WallaceClark W HeathRobert KusiakJoy L Herndon
- Publication Details
- The New England journal of medicine, v 313(4), pp 211-216
- Publisher
- Massachusetts Medical Society
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:A1985AMM5100002
- Scopus ID
- 2-s2.0-0021808358
- Other Identifier
- 991021895800404721
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- Collaboration types
- International collaboration
- Web of Science research areas
- Pharmacology & Pharmacy