儿童严重喘治疗中的广泛机构变化:一项多中心回顾性研究
Colin M Rogerson1, Alexander H Hogan2, Briana Waldo3
1Division of Pediatric Critical Care Medicine, Indiana University School of Medicine, Indianapolis, IN.
概括
对于儿童严重喘的辅助喘疗法在各医院之间存在很大差异. 治疗方法的这种变化没有影响住院时间或儿科重症监护室 (PICU) 入院率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 呼吸系统药物 呼吸系统药物
- 医疗服务研究 医疗服务研究
背景情况:
- 儿童的喘状况通常需要除了全身皮质类固醇和吸入β-激动剂之外的治疗方法.
- 在儿科重症监护室 (PICU) 缺乏国家喘管理指南.
研究的目的:
- 评估儿童患者使用辅助喘疗法的机构变异性.
- 评估这些疗法的使用与停留时间 (LOS) 和PICU入院率之间的关联.
主要方法:
- 多中心回顾性队列研究.
- 使用了来自儿科健康信息系统 (PHIS) 数据库 (2013-2021) 的行政数据.
- 包括213506例2至18岁儿童的住院喘病例,以及39个机构的29026例PICU病例.
主要成果:
- 在每次PICU遭遇使用的辅助疗法的数量和类型中观察到显著的机构变化.
- 每次遇到的辅助疗法的中位数在各机构中从0.6到2.5不等.
- 在使用的辅助疗法的平均数量和医院LOS或需要PICU护理的喘入院的百分比之间没有发现显著的关联.
结论:
- 在儿童医院中,对于状态喘的辅助疗法使用存在很大差异.
- 目前的辅助疗法实践没有被证明与改善的医院LOS或减少PICU入院率有关.
- 通过基于证据的指导方针来规范护理提供了一个优化结果和降低成本的机会.
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