Paediatric difficult intubations and the impact of timing of weekend versus weekday cases: an analysis of the Pediatric Difficult Intubation registry
Bibliographic record
Abstract
BACKGROUND: Off-hours presentation has been shown to be independently associated with tracheal intubation-related adverse events in patients with predicted difficult airway. The comparison of the complication rates of paediatric difficult intubations on weekends vs weekdays is unknown. The primary objective of this retrospective review is to determine the complication rates for paediatric difficult intubation cases that occur on a weekend vs a weekday. METHODS: We performed a retrospective review of data from the Pediatric Difficult Intubation registry, with service dates June 8, 2012 to May 9, 2023, to compare complication rates (total complications, hypoxaemia, non-hypoxaemia complications, and first-attempt success rate) during paediatric difficult intubations that occurred on the weekends vs weekdays. Research electronic data capture was used to standardise data collection across institutions. RESULTS: We reviewed a total of 8031 cases of difficult paediatric intubations. Two hundred and eighty-five (3.5%) were performed on the weekend, and 7746 (96.5%) were performed on a weekday. Complication rates with paediatric difficult intubations (total complications, hypoxaemia, and non-hypoxaemia complications) were significantly higher on weekends compared with weekdays. The odds of any complication were more than two times higher on the weekends compared with weekdays (odds ratio 2.13, 95% confidence interval 1.49-3.07, P<0.0001). CONCLUSIONS: This study supports paediatric anaesthetists' clinical decision-making to postpone nonurgent paediatric procedures in children with a history of a difficult airway from weekend to weekday to decrease risk of airway management complications and improve patient safety and quality of care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".