[Pediatric anesthesia services at German university hospitals : A descriptive analysis (2022-2024)].

Abstract

Background: University hospitals play a key role in research, clinical care and medical education; however, the number of pediatric anesthetic procedures performed at German university hospitals, including complex cases requiring specialized expertise and those relevant for training remains unknown.

Methods: All chairs of anesthesiology at German university hospitals were invited via email to participate in a survey. For the years 2022-2024, the number of anesthetic procedures, patient age groups (< 1, 1-4, 5-11, 12-17, ≥ 18 years) and the American Society of Anesthesiologists (ASA) classification of pediatric cases were collected. The primary endpoint was the percentage of pediatric anesthetic procedures relative to the total number of anesthetic procedures. Secondary variables included age distribution, relative proportion, ASA classification and case volume-dependent structure of pediatric anesthesia services.

Results: In this study 23 university hospitals participated (response rate: 43.6%). On average, 24,910 ± 9325 anesthetic procedures were performed per hospital and year. The proportion of children was 13.6% (of whom 11.6% were < 1 year and 31.8% aged 1-4 years). The relationship between total case volume and the pediatric proportion was positive and linear (y = 0.0017x + 7.0785; R² = 0.69). The ASA classification of children was distributed as follows: 47.9% ASA I, 28.5% ASA II, 20.0% ASA III, 3.3% ASA IV and 0.2% ASA V. Hospitals with the largest total caseloads had the highest pediatric proportion (16.5%), including the largest share of children aged 0-5 years (52.2%) and the highest proportions of ASA IV-V cases (27.6%).

Discussion: There were marked differences in case volume among university hospitals; however, a clear correlation was observed between total anesthetic case volume and the pediatric proportion. The findings suggest that pediatric anesthesia services are increasingly concentrated in large centers.