Retrospective Examination of Initial Care of Severe Bacterial Infections of the Child

Study Overview
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Brief Summary
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The aim of the study is to determine the frequency of sub-optimal care in the initial care (before arrival at the intensive care unit) of children from West France regions suffering of severe bacterial infections.The characteristic optimal or not of the initial medical care will be determined by 2 independent experts, blinded from each other and blinded from the issue of the care. In case of a discordance between the two experts, a third expert will be demanded. Three possibilities of conclusion will be proposed to the experts: sure sub-optimal medical care, possible suboptimal care and optimal care.

Official Title
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Frequency, Consequences and Determinants of Sub-optimal Care in the Initial Care of Severe Bacterial Infections of the Child

Conditions
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Bacterial Infection

Intervention / Treatment
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* Other: Retrospective examination by experts whether care given fo child admitted at the ICU for suspicion of bacterial infection (not nosocomial) was optimal or not


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child from West France regions Aged between 1 month and 16 years old, Admitted at the intensive care unit for a severe bacterial infection and with the first symptoms appeared when child was at home or hospitalized since less than 48h Children dead at home will also be included in this study via the mobil medical urgency help unit (french term : SAMU) Exclusion Criteria: Patient not fulfilling inclusion criteria Child with a nosocomial infection Child dead or admitted at the intensive care unit following a pertussis- Child not admitted at the intensive care or not dead at home in a context of infection. Child with viral or fungic infection admitted at the intensive care unit.

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Retrospective examination by experts whether care given fo child admitted at the ICU for suspicion of bacterial infection (not nosocomial) was optimal or not|When child is admitted at Intensive Care Unit (ICU) for suspicion of bacterial infection that is not nosocomial, data on child's infection and cares received, is completed on an electronic Case Report Form (e-CRF) by Doctor of ICU. Characteristic optimal or not of initial medical care is then determined by the independent experts blinded from issue of the care.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of optimal care and of non optimal care in the initial care (before arrival at the intensive care unit) of children (from West France regions) suffering of severe bacterial infections. | For each child medical file, the verdict optimal care or the verdict  non optimal care will be determined by two independent experts, blinded from each other. If verdict base their judgement through recommendations listed in the literature. | 1day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| characteristics of sub-optimal cares | Experts will explain their verdict by answering to a list of questions. These questions will allow to identify and classify characteristics of defaults of cares . | 1 day | 
| determinants of sub-optimal cares | To identify determinants of sub-optimal cares (examples : place of medical care, qualification and experience of the Medical Doctor, moment of medical care. | 1 day | 
| consequences of initial sub-optimal cares | To identify consequences of initial sub-optimal cares on the outcome of children with severe bacterial infections (child death, etc). | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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severe bacterial infection