Caregiver Concern Can Be Key to Identifying Critical Illness in Hospitalized Children

FRIDAY, June 6, 2025 (HealthDay News) — For pediatric patients presenting to a hospital, caregiver concern for clinical deterioration is associated with critical illness, according to a study published online May 29 in The Lancet Child and Adolescent Health.

Erin Mills, M.B.B.S., from Monash University in Melbourne, Australia, and colleagues conducted a prospective observational cohort study to examine the relationship between documented caregiver concern about clinical deterioration and critical illness in children presenting to a hospital.

Overall, 73,845 children had eligible emergency department presentations, of which 24,239 had at least one documented response for parent or caregiver concern. The researchers collected 189,708 responses; 4.7 percent indicated concern for clinical deterioration. Patients with a caregiver reporting concern for clinical deterioration were more likely than those without documented concerns to be admitted to the intensive care unit (ICU; 6.9 versus 1.8 percent), be mechanically ventilated (1.1 versus 0.2 percent), or die during admission (0.1 versus 0.02 percent). In a multivariable analysis, caregiver concern for clinical deterioration was associated with ICU admission and mechanical ventilation but not with death. Caregiver concern was more strongly associated with ICU admission than any abnormal vital sign (adjusted odds ratios ranging from 1.12 to 1.26 for abnormal heart rate and abnormal respiratory rate, respectively) after adjustment for other variables.

“Parents and caregivers are a resource that can assist clinicians to monitor for deterioration, and they might perform better than some current systems reliant on vital signs alone,” the authors write.

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