对明显危及生命的事件进行简要的解决不明原因事件分类的临床效用和患者分布
Daiki Tanaka1, Shunsuke Amagasa1, Nanae Kikuchi1
1From the Division of Emergency and Transport Services.
Pediatric emergency care
|June 15, 2023
概括
简要解决的不明原因事件 (BRUE) 标准很难应用于所有明显危及生命的事件 (ALTE). 虽然较低风险的BRUE病例没有不良结果,但BRUE分类可能有助于管理某些儿科急诊患者.
科学领域:
- 儿科急救医学 儿科急救医学
- 临床分类系统临床分类系统
背景情况:
- 简要解决的不明原因事件 (BRUE) 于2016年推出,作为明显危及生命的事件 (ALTE) 的继承者.
- 使用BRUE标准来管理ALTE病例的临床适用性仍在争论中.
研究的目的:
- 通过评估ALTE患者来评估BRUE标准的临床实用性.
- 确定符合BRUE标准的ALTE患者的比例,并分析他们的诊断和结果.
- 为了比较符合BRUE标准 (高风险和低风险) 和不符合标准 (ALTE-not-BRUE) 的患者之间的结果.
主要方法:
- 对192名患有ALTE的儿科患者 (<12个月) 进行了回顾性分析,这些患者在国家儿童医院接受治疗 (2008年4月至2020年3月).
- 患者被分为较高风险的BRUE,较低风险的BRUE或ALTE-not-BRUE组.
- 评估诊断和不良结果 (死亡,复发,吸血,窒息,创伤,感染,,心脏病,代谢疾病,过敏).
主要成果:
- 140名患者 (71%) 被归类为ALTE-not-BRUE,43人 (22%) 被归类为高风险的BRUE,9人 (5%) 被归类为低风险的BRUE.
- 在27名ALTE非BRUE患者和10名高风险BRUE患者中发生了不良结局.
- 在风险较低的BRUE组中没有观察到任何不良结果.
结论:
- 很大一部分ALTE病例不符合BRUE标准,这表明用BRUE取代ALTE存在挑战.
- 在儿科紧急情况下,BRUE风险分层可能会带来好处,特别是用于识别具有有利结果的低风险病例.
- 需要进一步的研究来完善BRUE标准在不同ALTE群体中的应用.
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