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对新生儿早期发作的败血症进行增强的基于类别的风险评估:一项前性观察性研究

Hoi Ying Sharon Lau¹, Xuelian Wang², Ho Tsun Michelia Wong³

¹Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China, sharonlauhy@gmail.com.

|October 31, 2023

概括

一个新的增强的基于类别的风险评估 (eCRA) 框架可以安全地减少早发性败血症 (EOS) 的入院和新生儿的抗生素使用. 这种方法与EOS计算器的性能相匹配,不需要电子工具.

科学领域:

新生儿医学新生儿医学
传染病流行病学传染病流行病学
临床风险评估临床风险评估

背景情况:

传统的基于类别的风险评估 (CRA) 新生儿早期发作的败血症 (EOS) 是简单的,但导致高抗生素使用.
多变量风险评估提供了替代方案,但可能是复杂的,需要电子设备.

研究的目的:

评估用于EOS查的新增增强型CRA (eCRA) 框架.
评估eCRA对EOS入院和抗生素利用的影响.
为了确定修改后的ecra是否可以与eos计算器的性能相匹配,同时保持易于实现.

主要方法:

一个前性的,单中心的,两阶段的观察性研究,涉及有风险的新生儿.
第一阶段:比较了新的eCRA框架与基于CDC2010的协议.
第二阶段:理论上将修改后的ecra框架与eos计算器进行比较,测量eos入院和抗生素使用.

主要成果:

第一个阶段的eCRA显示,EOS入院率 (45.8%至29.4%) 和抗生素使用率 (41.1%至28.2%) 显著下降.
在看起来健康,有风险的婴儿中,抗生素的使用率从25.3%降至16.3% (p < 0.001).
第二阶段发现修改后的eCRA和EOS计算器之间类似的抗生素使用 (7.3%对6.4%,p = 0.42).

结论:

增强的CRA (eCRA) 框架有效和安全地指导个性化的EOS查.
eCRA为电子工具 (如EOS计算器) 提供了一个可行的替代方案.
这种方法可以帮助优化新生儿护理中的抗生素管理.

关键词:

基于类别的风险评估.新生儿败血症新生儿败血症新生儿婴儿新生儿婴儿

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