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预测儿科败血症死亡率:使用儿科败血症监测方法进行全国数据分析
Shinya Miura1, Nobuaki Michihata2
1Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan.
概括
电子健康记录监测有效地识别了儿科败血症,这是一种经常与高死亡风险相关的疾病. 这种方法可以根据器官功能障碍准确预测儿童的住院死亡.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 电子健康记录 (EHR) 监控在成人败血症流行病学中很常见.
- 它在儿童群体中的使用是有限的,因此儿童败血症流行病学在很大程度上是未知的.
- 这项研究解决了验证EHR监测的必要性,以确定高风险的儿科败血症病例.
研究的目的:
- 确定基于EHR的监测是否可以识别高死亡风险的败血症儿童.
- 评估这种方法在现实世界儿科住院患者环境中的准确性.
主要方法:
- 在日本 (2014-2021) 利用全国性住院患者数据库.
- 包括接受血培养和抗微生物药物的4天以上的儿童.
- 根据器官功能障碍将患者分层分为败血症和非败血症组;评估死亡率歧视.
主要成果:
- 入院死亡率为败血症的7.2%,而非败血症的0.2% (n=6553).
- 败血症诊断显示出死亡率的高度歧视 (灵敏度0.84,特异性0.87).
- 随着器官功能障碍的数量 (0-5) 的增加,死亡风险显著增加.
结论:
- 基于EHR的监测有效地识别了患有高死亡风险的儿科败血症病例.
- 该方法表现出强大的歧视能力,用于预测儿童在医院死亡率.
- 器官功能障碍的数量是儿科败血症死亡风险的关键指标.
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