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糖尿病酸症儿童不良后果的危险因素
Maha F Yousif1, Katie D Dolak1, Soumya Adhikari1
1Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX 75390, USA.
一个新的模型确定了患有糖尿病酸性酸症 (DKA) 和高血糖超状况 (HHS) 的儿童面临不良结果的风险. 2型糖尿病和初始高血糖/酸严重程度是关键预测因素,解释了COVID-19大流行期间风险增加的原因.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 关键护理医学 关键护理医学
- 糖尿病研究研究 糖尿病研究
背景情况:
- 糖尿病酸性酸症 (DKA) 和高血糖性超性状态 (HHS) 是儿童糖尿病的严重急性并发症.
- 识别患有不良结果高风险的儿童对于及时干预至关重要.
- COVID-19 流行病可能影响了这些疾病的发病率和严重程度.
研究的目的:
- 开发和验证一个多变量预测模型,用于儿科DKA/HHS的不良结果.
- 评估COVID-19大流行对这些患者不良结果的影响.
- 确定与儿科DKA/HHS中不良结果相关的关键风险因素.
主要方法:
- 从2010年至2023年在一家大型儿童医院对4565例DKA/HHS儿科住院病例进行了回顾性审查.
- 数据分为培训 (2010-2019) 和验证 (2020-2021, 2022-2023) 的数据集.
- 用于评估死亡或ICU停留时间>48小时的复合结果风险的概括估计方程.
主要成果:
- 不良结果发生在1.5% (2010-2019),5.0% (2020-2021) 和2.4% (2022-2023) 的入院患者中.
- 最大血清葡萄糖,初始pH值和2型糖尿病诊断是不良结果的强有力的预测因素.
- 预测模型在数据集之间显示出出色的歧视 (AUC 0.948-0.960).
结论:
- 2型糖尿病和高血糖/酸性疾病的严重程度是儿童DKA/HHS中不良结果的独立风险因素.
- 这些因素解释了COVID-19大流行期间观察到的不良结果的频率增加.
- 从2022年1月到2023年6月,人们注意到不良结果风险的显著下降.
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