通过特殊医疗保健需要状态来比较儿科身体创伤结果
Denise F Lillvis1,2,3, Karen M Sheehan4, Jihnhee Yu5
1John R. Oishei Children's Hospital, Buffalo, New York.
Hospital pediatrics
|August 16, 2023
概括
具有特殊医疗保健需求的儿童和青少年 (CYSHCN) 面临更高的医院并发症风险和创伤后更长的住院时间. 这些风险对CYSHCN来说甚至更大,伤害不那么严重.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 医疗保健的不平等 医疗保健的不平等
- 公共卫生 公共卫生
背景情况:
- 与同龄人相比,有特殊医疗保健需求的儿童和青少年 (CYSHCN) 呈现出明显的风险因素和受伤模式.
- 了解这些差异对于优化创伤护理结果至关重要.
研究的目的:
- 调查特殊医疗保健需求 (SHCN) 状态和创伤后的医院结果之间的关联.
- 分析儿科创伤患者的并发症,死亡率和停留时间 (LOS),有或没有SHCN.
主要方法:
- 使用2018年国家创伤数据库数据 (n=108,062名儿科患者) 的横截面研究.
- 检查了包括并发症,ICU入院,死亡率和LOS在内的医院结果.
- 多变量回归模型对人口统计,受伤严重程度和格拉斯哥昏迷评分进行了控制.
主要成果:
- 在CYSHCN患者中,住院并发症的风险显著增加 (ARR=2.980) 和非计划性重症监护室入院 (ARR=1.996).
- CYSHCN经历了更长的住院时间 (IRR=1.119) 和ICU LOS (IRR=1.319).
- 在住院死亡率上没有显著差异;较低严重程度的创伤扩大了CYSHCN的并发症风险.
结论:
- CYSHCN,特别是那些患有较低急性伤害的人,面临复杂症的风险增加,并且需要增加创伤后的护理.
- 进一步的研究应该探索CYSHCN并发症的机制,以制定有针对性的预防策略.
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