儿科重症监护使用风险的预测模型在有医疗复杂性的儿童:一个纵向回顾性队列研究
Bibiana Pérez-Ardanaz1,2, Laura Gutiérrez-Rodríguez2,3, Alberto José Gómez-González2,3
1Department of Nursing, Faculty of Health Sciences, Universidad de Granada, Granada, Spain.
Nursing in critical care
|October 9, 2024
概括
患有医疗复杂性 (CMC) 的儿童面临更高的重症监护风险. 母亲的教育和年龄是保护因素,这表明社会人口统计学因素可以防止儿童重症监护室 (PICU) 的入院.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 患有医疗复杂性 (CMC) 的儿童有进入重症监护室 (ICU) 的风险较高.
- 尽管死亡率有所改善,但CMC体验了显著的发病率,长期医疗保健需求和医院再入院.
- 除了临床方面之外,社会人口因素可能会影响CMC的急性服务利用率.
研究的目的:
- 确定 CMC 进入儿科重症监护室 (PICU) 的风险因素.
- 探索临床,社会人口和医疗保健利用变量对PICU入院风险的影响.
主要方法:
- 一个长度6年的回顾性队列研究.
- 评估临床数据,社会人口统计信息和医疗保健利用模式.
- 统计分析包括危险比率 (HR) 和多变量分析.
主要成果:
- 这项研究包括248名CMC,其PICU入院率为47.2%.
- 手术干预 (HR=1.58) 和家庭医疗设备 (HR=1.81) 增加了PICU入院风险.
- 较高的母亲教育水平 (HR=0.66) 是一个保护因素;在多变量分析中,年龄和母亲教育是保护因素.
结论:
- 社会人口因素,特别是母亲的教育,对于管理CMC护理至关重要.
- 考虑社会经济决定因素的个性化评估可能会阻止PICU入院.
- 将社会人口风险评估纳入临床实践,特别是儿童护士的临床实践,可以优化护理和支持干预.
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