需要早期PICU再入院的患者的频率,特征和结果
Eleanor A Sharp1, Li Wang2, Matt Hall3
1Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Hospital pediatrics
|July 21, 2023
概括
早期重新入住儿科重症监护室 (PICU) 是不常见的,但与更糟糕的结果有关. 患有复杂慢性疾病 (CCC) 的患者面临PICU再入院的最高风险.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
背景情况:
- 重新入住儿科重症监护室 (PICU) 与患者的不良结果有关.
- 在同一个住院期间,了解导致早期PICU再入院的因素对于改善护理至关重要.
研究的目的:
- 为了确定早期PICU再入院的患病率.
- 为了确定与早期PICU再入院相关的患者和临床因素.
主要方法:
- 在48家儿童医院 (2016-2019) 进行了389,219次PICU入院病人的回顾性分析.
- 早期再入院的定义:在同一住院期间,在楼层转移后2天内返回PICU.
- 一般化的线性混合模型用于评估与患者/临床变量相关的关联,包括复杂慢性疾病 (CCC).
主要成果:
- 早期的PICU再接收率为2.5%,为2%.
- 最高的再接收率与具有≥4个CCCs (aOR4.2),腹腔营养 (aOR2.3) 和腹腔关节 (aOR1.9) 相关.
- 降低再接收几率的因素包括体外膜氧化 (aOR 0.4) 和心肺复苏 (aOR 0.8).
- 早期再入院与更长的逗留时间和增加的死亡率相关 (aOR 1.7).
结论:
- 早期的PICU再入院,虽然不频繁,但显著恶化了临床结果.
- 具有医疗复杂性和技术依赖性的患者特别容易受到早期再入院的影响.
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