在急救部门出院后,儿童的临界再访
Sarah C Cavallaro1, Kenneth A Michelson1, Gabrielle D'Ambrosi1
1Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.
Annals of emergency medicine
|July 18, 2023
概括
在儿童中,重复访问急诊室 (ED) 是罕见的,但喘和复杂的慢性疾病会增加风险. 识别这些高风险群体可以帮助防止在ED免费后出现严重的结果.
科学领域:
- 儿科急救医学 儿科急救医学
- 改善医疗保健质量 改善医疗保健质量
- 公共卫生 公共卫生
背景情况:
- 紧急部门 (ED) 的重新访问可能表明不理想的护理,并导致患者的不良结果.
- 识别面临临重复临床检查的高风险儿童对于制定有针对性的预防策略至关重要.
研究的目的:
- 确定从ED出院的儿童中关键ED重访的比例.
- 确定与儿科患者的重复临床检查相关的因素.
主要方法:
- 使用大规模ED和住院患者数据库 (2014-2017年) 的回顾性研究.
- 定义关键ED重访作为ICU入院或离院后3天内死亡.
- 分析了诊断和慢性疾病的相对风险 (RR) 和发病率比率 (IRR).
主要成果:
- 分析了超过1600万名儿科ED出院的情况.
- 关键ED复诊率为0.1% (18,704例),死亡率很少见.
- 喘显著增加了复诊风险 (RR 2.24);复杂的慢性疾病也增加了风险 (IRR 11.03).
结论:
- 在ED出院后的儿童中,危急的再访和相关的死亡不常见.
- 患有喘和复杂慢性疾病的儿童代表了危险重访的高风险群体.
- 进一步的研究应该集中在这些高风险人群上,以改善护理过渡.
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