TY - JOUR
T1 - Continued reduction in peritonitis rates in pediatric dialysis centers
T2 - results of the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative
AU - for the SCOPE Collaborative Participants
AU - Neu, Alicia M.
AU - Richardson, Troy
AU - De Souza, Heidi Gruhler
AU - Mahon, Allison Redpath
AU - Keswani, Mahima
AU - Zaritsky, Joshua
AU - Munshi, Raj
AU - Swartz, Sarah
AU - Sethna, Christine B.
AU - Somers, Michael J.G.
AU - Warady, Bradley A.
N1 - Publisher Copyright:
© 2021, IPNA.
PY - 2021/8
Y1 - 2021/8
N2 - Background: In its first 3 years, the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative demonstrated a statistically significant increase in the likelihood of compliance with a standardized follow-up care bundle and a significant reduction in peritonitis. We sought to determine if compliance with care bundles and low peritonitis rates could be sustained in centers continuously participating for 84 months. Methods: Centers that participated from collaborative launch through the 84-month study period and provided pre-launch peritonitis rates were included. Children on maintenance peritoneal dialysis were eligible for enrollment. Changes in bundle compliance were assessed using a logistic regression model or a generalized linear mixed model (GLMM). Changes in average annualized peritonitis rates over time were modeled using GLMMs. Results: Nineteen centers contributed 1055 patients with 1268 catheters and 17,247 follow-up encounters. The likelihood of follow-up compliance increased significantly over the study period (OR 1.05 95% confidence interval (CI) 1.03, 1.07; p < 0.001). Centers achieved ≥ 80% follow-up bundle compliance by 28 months and maintained a mean compliance of 84% between 28 and 84 months post-launch. Average monthly peritonitis rates decreased from 0.53 (95% CI 0.37, 0.70) infections per patient-year pre-launch to 0.30 (95% CI 0.23, 0.43) at 84 months post-launch, p < 0.001. Conclusions: Centers participating in the SCOPE Collaborative for 84 months achieved and maintained a high level of compliance with a standardized follow-up care bundle and demonstrated a significant and continued reduction in average monthly peritonitis rates. Graphical abstract: [Figure not available: see fulltext.].
AB - Background: In its first 3 years, the Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative demonstrated a statistically significant increase in the likelihood of compliance with a standardized follow-up care bundle and a significant reduction in peritonitis. We sought to determine if compliance with care bundles and low peritonitis rates could be sustained in centers continuously participating for 84 months. Methods: Centers that participated from collaborative launch through the 84-month study period and provided pre-launch peritonitis rates were included. Children on maintenance peritoneal dialysis were eligible for enrollment. Changes in bundle compliance were assessed using a logistic regression model or a generalized linear mixed model (GLMM). Changes in average annualized peritonitis rates over time were modeled using GLMMs. Results: Nineteen centers contributed 1055 patients with 1268 catheters and 17,247 follow-up encounters. The likelihood of follow-up compliance increased significantly over the study period (OR 1.05 95% confidence interval (CI) 1.03, 1.07; p < 0.001). Centers achieved ≥ 80% follow-up bundle compliance by 28 months and maintained a mean compliance of 84% between 28 and 84 months post-launch. Average monthly peritonitis rates decreased from 0.53 (95% CI 0.37, 0.70) infections per patient-year pre-launch to 0.30 (95% CI 0.23, 0.43) at 84 months post-launch, p < 0.001. Conclusions: Centers participating in the SCOPE Collaborative for 84 months achieved and maintained a high level of compliance with a standardized follow-up care bundle and demonstrated a significant and continued reduction in average monthly peritonitis rates. Graphical abstract: [Figure not available: see fulltext.].
KW - Infection
KW - Peritoneal dialysis
KW - Peritonitis
KW - Prevention
KW - Quality improvement
UR - http://www.scopus.com/inward/record.url?scp=85101805799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85101805799&partnerID=8YFLogxK
U2 - 10.1007/s00467-021-04924-0
DO - 10.1007/s00467-021-04924-0
M3 - Article
C2 - 33649895
AN - SCOPUS:85101805799
SN - 0931-041X
VL - 36
SP - 2383
EP - 2391
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 8
ER -