对于新型气管切除术后的儿童来说,低资源的医院日
Cara A Cecil1, Adam C Dziorny2, Matt Hall3
1Ann and Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Pediatrics
|August 8, 2024
概括
对于需要气管切除和机械通风的儿童来说,低资源日 (LRD) 是常见的. 年轻的年龄,早期的气管切除术,亚洲种族和更长的住院时间增加了LRD风险,影响了过渡期护理资源的利用率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗保健资源利用情况
- 过渡期护理模式的模型
背景情况:
- 需要气管切除术和侵入性机械通风 (IMV) 的儿童需要专门的过渡护理.
- 在这个阶段了解医院资源的使用对于优化患者护理和运营效率至关重要.
研究的目的:
- 定义和描述儿科患者的低资源日 (LRD) 新的气管切除术和IMV.
- 为了确定与LRDs在这个人群中发生相关的因素.
主要方法:
- 对儿童 (≤21岁) 进行了回顾性队列分析,这些儿童接受了新的气管切除术和IMV依赖 (2017-2022年).
- 使用了儿科健康信息系统数据库.
- 定义的LRD是气管切除术后的几天,非房间费用<手术后第一天费用的10%;使用负二项回归分析的因素.
主要成果:
- 在4048名儿童中,38.6%患有≥1次LRD,16.4%患有≥7次LRD.
- 气管切除术的年龄较小,亚洲种族,早期的气管切除术和更长的气管切除术后住院时间与LRDs的增加有关.
- 气管切除术后的平均停留时间为69天.
结论:
- 几乎六分之一的儿童经历了7次或更多的LRD,这表明发生了重大事件.
- 与LRDs相关的关键因素包括年轻年龄,早期气管切除术,亚洲种族和长时间住院.
- 研究结果强调需要探索IMV依赖儿童的创新护理模式,重点关注后急性阶段和床位利用.
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