儿科重症监护病房中的各种评分系统:一项前性观察研究
Jyotsna1, Rakesh Kumar1, Shambhavi Sharan1
1Pediatrics, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus
|July 3, 2023
概括
在印度,像PRISM 4和PIM 3这样的儿科评分系统可能无法准确预测重症儿童的结果. 该研究发现,儿科序列器官衰竭评估 (pSOFA) 和儿科物流器官功能障碍 (PELOD) 2分数是死亡率的可靠预测指标.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 已建立的儿科评分系统 (PRISM,PIM,SOFA,PELOD) 在印度等不同医疗保健环境中可能具有有限的适用性.
- 由于患者群体和疾病因素的潜在差异,这些得分的验证至关重要.
- 这项研究解决了在印度背景下评估现有的评分系统的需要.
研究的目的:
- 为了比较PRISM 4,PIM 3,PELOD 2和pSOFA分数在预测印度重症儿童预后方面的表现.
- 分析儿童重症监护病房 (PICU) 住院儿童的临床谱和人口特征.
- 确定不同评分系统与患者结果之间的相关性,包括死亡率和停留时间.
主要方法:
- 一个前性的,单中心的观察性研究是在印度帕特纳的一个PICU中进行的,持续了两年.
- 招募了200名1个月至14岁的儿童.
- PRISM 4和PIM 3用于预测结果和死亡率,而PELOD 2和pSOFA评估器官功能障碍;与结果的相关性被分析.
主要成果:
- 该研究包括200名儿童,其中大多数是男性 (66.5%) 和1-3岁 (26.5%).
- 脏并发症是最常见的入院诊断 (19%). 总体死亡率为18.5%,婴儿<1岁和男性的死亡率最高.
- 在死亡率和PRISM 4,PIM 3,PELOD 2和pSOFA入院时的得分之间发现了显著的正相关性 (p<0.00001). pSOFA (AUC:0.77) 和PELOD2 (AUC:0.74) 显示出更强大的区分能力.
结论:
- 儿科序列器官衰竭评估 (pSOFA) 和儿科物流器官功能障碍 (PELOD) 2分数是严重疾病的印度儿童死亡率的可靠预测指标.
- 这些分数在这个人群中提供了比PRISM 4和PIM 3更好的歧视能力.
- 这些发现支持pSOFA和PELOD2用于印度PICU的风险分层和结果预测.
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