美国PICU中患有呼吸衰竭的青少年和年轻成年人:儿科健康信息系统数据库研究,2011-2022年
Kevin S Gochenour1, Melissa H Ross1, Heidi R Flori2
1Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI.
概括
患有呼吸衰竭的青少年和年轻人 (AYA) 进入儿科重症监护室 (PICU) 的死亡率和资源使用率更高. 在AYA中独特的并发症突显了对专业护理过渡策略的需求.
科学领域:
- 关键护理医学 关键护理医学
- 儿科肺病学 儿科肺病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 青少年和年轻成年人 (AYA) 是儿科重症监护室 (PICU) 的重要患者群体.
- 呼吸衰竭是各种年龄段的PICU入院的常见原因之一.
- 了解患有呼吸衰竭的AYA的特定需求对于优化护理至关重要.
研究的目的:
- 调查接受呼吸衰竭的PICU的AYA的临床特征.
- 分析呼吸衰竭的AYA的结果和资源利用情况.
- 为了比较AYA与年轻的儿科患者关于并发症和重症监护管理.
主要方法:
- 这是一项回顾性队列研究,使用了儿科健康信息系统 (PHIS) 数据库中的非识别数据.
- 从2011年1月到2022年12月,美国48家儿童医院的430,238名因呼吸衰竭而入院的PICU患者的分析.
- 患者被分为五个年龄队列:<15,15-18,19-21,22-25和>25岁.
主要成果:
- 在所有因呼吸衰竭而入院的PICU中,AYA (≥15年) 占15%.
- 较年长的AYA (> 25岁) 与较年轻的儿童 (< 15岁) 相比,表现出更高的医疗技术依赖率 (49%) 和心血管相关疾病 (61%).
- 与年轻患者相比,AYA的原始死亡率 (7.7%) 和中位数医院费用 (163,000美元) 较高,尽管幸存者的呼吸机日数和住院时间相似.
结论:
- 患有呼吸衰竭的AYA代表着一个相当大的PICU人群,具有明显的并发症概况和增加的死亡风险.
- 在AYA的医疗复杂性和儿科疾病的后果可能会阻碍他们过渡到成人护理.
- 儿科和成人重症监护专家之间的加强合作对于制定基于证据的指导方针和改善跨年龄范围的护理至关重要.
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