胸部放射学与儿科肺炎的结果的关联:基于人口的研究
Alexandra T Geanacopoulos1,2, Mark I Neuman1,2, Susan C Lipsett1,2
1Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Hospital pediatrics
|June 21, 2023
概括
从急诊室出院的社区获得性肺炎 (CAP) 儿童的胸部X射线 (CXR) 与7天住院病例略有减少有关. 这表明CXRs有助于对儿科CAP患者的预后评估.
科学领域:
- 儿科急救医学 儿科急救医学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 社区获得性肺炎 (CAP) 是儿童出现在急诊室 (ED) 的常见诊断.
- 胸部放射 (CXR) 经常用于在ED环境中评估CAP.
- 对于从ED出院的儿科CAP患者,CXR对临床结果的影响需要进一步调查.
研究的目的:
- 在被诊断为CAP的儿童中,评估接受CXR和在ED出院后住院7天之间的关联.
- 评估患者和ED水平的CXR表现与随后的住院治疗之间的关系.
主要方法:
- 在8个州 (2014-2019) 的3个月至17岁的儿童从ED医院出院的回顾性队列研究.
- 混合效应物流回归模型被用于分析CXR与7天住院治疗的关联,并根据疾病严重程度进行调整.
- 二次结果包括为期7天的ED复诊和因严重CAP而住院.
主要成果:
- 在206,694名患有CAP的儿童中,七天住院率为1.6%.
- 调整后的分析显示,CXR与7天住院减少有关 (aOR:0.82,95%CI:0.73-0.92).
- 具有较高CXR利用率的ED显示,7天住院,ED复诊和严重CAP住院率明显较低.
结论:
- 在从ED出院的CAP儿童中,CXR的表现与统计学上显著的,尽管很小,但7天住院治疗的减少有关.
- 在急诊室管理的儿科CAP患者中,CXR可以作为预后评估的宝贵工具.
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