美国儿童急性呼吸衰竭的流行病学:结果和资源使用
Folafoluwa O Odetola1,2, Achamyeleh Gebremariam2
1Division of Pediatric Critical Care Medicine, Department of Pediatrics.
Hospital pediatrics
|July 2, 2024
概括
儿童急性呼吸衰竭的护理因医院类型和技术获取而有很大差异. 优化结果需要解决医院间转移问题,并确保重症儿童平等获得器官支持技术.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗经济学
背景情况:
- 儿童急性呼吸衰竭 (ARF) 往往需要先进的器官支持技术.
- 这些技术的可用性变化可能会影响患者的治疗结果和资源利用.
- 了解这些变化对于改善护理服务至关重要.
研究的目的:
- 测试该假设,儿童ARF患者的患者结果和资源使用因患者特征,医院特征和接受器官支持技术而有所不同.
- 确定与儿童ARF死亡率,住院时间和成本相关的因素.
- 为优化护理和资源分配的战略提供信息.
主要方法:
- 2019年儿童住院患者数据库的回顾性分析.
- 包括因ARF住院的0至20岁儿童.
- 多变量回归模型用于确定死亡率,停留时间和成本的预测因素.
主要成果:
- 该研究分析了75,365次住院治疗,主要是在城市教学医院.
- 复杂的慢性疾病 (62%),多器官功能障碍 (35%) 和极端疾病严重程度 (54%) 是常见的.
- 死亡率为7%,器官功能障碍和复杂的慢性疾病等因素增加了风险,而体外膜氧化和气管切除术与较低的死亡率有关.
结论:
- 儿科ARF住院导致显著的死亡率和资源消耗.
- 医院间转移,获得器官支持技术以及城市医院资源利用模式是需要改进的关键领域.
- 需要有针对性的干预措施来减少儿科ARF护理中的死亡率和资源使用.
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