更新新生儿早发性败血症计算器使用当代队列计算器
Michael W Kuzniewicz1,2,3, Gabriel J Escobar4, Heather Forquer1
1Division of Research.
Pediatrics
|September 24, 2024
概括
新生儿早期性败血症 (EOS) 风险分层的更新计算器显示,识别病例的敏感性有所提高,并保持低抗生素使用率. 这种工具有助于安全地减少新生儿的抗生素暴露.
科学领域:
- 新生儿医学 新生儿医学
- 儿童传染病 儿童传染病
- 临床风险评估临床风险评估
背景情况:
- 凯泽永久新生儿早发性败血症 (EOS) 计算器有助于风险分层,以减少新生儿的抗生素暴露.
- 最初的计算器是基于1993-2007年间的数据,此前美国产科实践的变化,如普遍的B组链球菌查和更新的产后抗生素预防指南.
研究的目的:
- 更新使用当代出生队列 (2010-2020) 的EOS计算器.
- 评估更新数据对EOS病例确定和抗生素建议的影响.
主要方法:
- 重估了模型系数和临床状况的概率比,使用来自14家医院的412,595名婴儿的数据.
- 在原始和更新模型之间比较了灵敏度 (正确识别的EOS病例) 和推实证抗生素的婴儿比例.
主要成果:
- 与原始模型 (0.76) 相比,更新的模型显示出稍高的灵敏度 (0.80),尽管在统计学上并不显著 (P = .15).
- 经验性抗生素建议是相似的:原始模型为3.5%,更新模型为3.7% (P < .0001).
- 更新的模型发现了更多的EOS病例,但治疗每一个额外的确定的病例将需要额外的158名婴儿用抗生素治疗.
结论:
- 原始和更新的EOS计算器都有效量化早发性败血症风险在35周妊娠或之后出生的婴儿.
- 更新后的计算器提供了更好的灵敏度,同时保持了低的经验性抗生素使用率.
相关概念视频
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
Healthcare Associated Infections II: Preventive Measures
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...


