儿科脏创伤的国家管理趋势 - 我们还在那里吗?
R Scott Eldredge1, Brielle Ochoa2, David Notrica2
1Mayo Clinic, Department of General Surgery, Phoenix, AZ, USA; Phoenix Children's, Division of Pediatric Surgery, Phoenix, AZ, USA.
Journal of pediatric surgery
|November 12, 2023
概括
大多数儿科的骨伤害发生在成人医院,但儿童医院处理更严重的病例. 在成人中心接受治疗的儿童面临脊髓切除术的三倍风险,儿童医院看到严重病例和脊髓切除率的增加.
科学领域:
- 儿科手术 儿科手术
- 创伤管理 创伤管理
- 外科手术的结果
背景情况:
- 建议在血液动力学稳定的儿科粗脊髓损伤 (BSI) 中进行非手术治疗.
- 儿科BSI非手术治疗的国家趋势需要调查.
研究的目的:
- 确定儿科粗脊髓损伤 (BSI) 非手术治疗的当代国家趋势.
主要方法:
- 对KIDS数据库 (2012-2019) 的回顾性审查.
- 分析儿科BSI病例 (年龄≤16岁).
- 医院类型之间的人口统计,伤害严重程度和干预措施的比较.
主要成果:
- 在8296个确定的BSI中,74.3%在非儿科医院接受治疗.
- 切除术率在全国范围内保持稳定 (6.8%与7.1%相比),但在成人中心 (11.9%与4.4%相比) 较高.
- 成人中心的儿科BSI显示,脊髓切除术的风险增加了3倍 (OR 3.50).
- 儿童医院的高度BSI (14.6%至51.7%) 和脊髓切除率 (1%至4%) 增加.
结论:
- 超过70%的儿科脏损伤在成人医院接受治疗,尽管儿童医院可以处理更高级别的损伤.
- 在成人中心接受治疗的儿童患脊髓切除术的可能性明显更高,即使控制了混因素.
- 儿童医院的病例和脊髓切除率越来越严重,需要进一步调查.
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