在儿童急性呼吸困扰综合征后的再入院率
Garrett Keim1,2,3, Jesse Y Hsu4, Neethi P Pinto1,2
1Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JAMA network open
|September 8, 2023
概括
患有急性呼吸窘迫综合征 (ARDS) 的儿童幸存者面临着高达30%的1年再入院率. 慢性疾病,气管切除术和长时间住院显著增加了这些儿童的再入院风险.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 肺部病理学 肺部病理学
- 医疗服务研究 医疗服务研究
背景情况:
- 越来越多的儿童在急性呼吸窘迫综合征 (ARDS) 中幸存下来.
- 儿童ARDS幸存者的长期发病率,包括医院再入院率和相关因素,在很大程度上是未知的.
- 了解这些因素对于改善出院后的护理和减少医疗保健负担至关重要.
研究的目的:
- 为了确定小儿ARDS幸存者的1年住院再接收率.
- 研究医院住院指数因子复杂慢性疾病,气管切除术和住院时间 (LOS) 与1年再入院的关联.
主要方法:
- 使用IBM MarketScan数据库 (2013-2018) 进行的回顾性队列研究.
- 包括患有机械通风ARDS的儿童 (≥28天至<18岁),这些儿童存活到出院.
- 考克斯的比例危险模型分析了住院因素和1年全因再入院之间的关联.
主要成果:
- 在13,505名儿科ARDS幸存者中,1年的再入院率为30.0%.
- 再接收的情况集中在释放后的61天内.
- 呼吸道和非呼吸道复杂慢性疾病,气管切除术和LOS≥14天都与增加的再入院风险有显著联系.
结论:
- 儿科ARDS幸存者有一个相当大的负担1年的医院再入院.
- 复杂慢性病的存在,气管切除术的安置和长时间的指数住院是重新入院的关键预测因素.
- 进一步研究释放后的干预措施是有必要的,以减轻再接收率.
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