在重症儿童中评估出血评估尺度的可靠性 (BASIC) 定义:前性队列研究
Marianne E Nellis1, Madhuradhar Chegondi2, Ariane Willems3,4
1Division of Pediatric Critical Care, Department of Pediatrics, Weill Cornell Medicine, New York, NY.
概括
重症儿童出血评估尺度 (BASIC) 定义可靠地对儿科重症监护病房的出血严重程度进行分类. 这种工具可确保对重症儿童的更好的临床和研究结果进行一致的评估.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 血液学 血液学 血液学
- 临床研究方法论 临床研究方法论
背景情况:
- 流血是重症儿童常见的并发症,影响结果.
- 对出血严重程度的标准化定义对于一致的临床管理和研究至关重要.
- 重症儿童出血评估量表 (BASIC) 是为了分类出血严重程度而开发的.
研究的目的:
- 评估 BASIC 定义在一组多样化的重症儿童中的可靠性.
- 为了评估BASIC定义的互评分和内评分可靠性.
- 探索出血严重程度与临床结果之间的关联.
主要方法:
- 在三个国家的八个混合儿科重症监护室 (PICU) 进行了前性队列研究.
- 招募了328名年龄在0-18岁的儿童,有明显的出血.
- 两位独立的医生在两个时间点分类出血事件为最小,中度或严重.
主要成果:
- 观察到相当大的总体评价者间可靠性 (加权卡帕:0.736) 和几乎完美的评价者内可靠性 (加权卡帕:0.816).
- 血小板计数,前激素时间,激活的局部血栓形成时间和纤维素原水平与出血严重程度有关.
- 更严重的出血与增加的28天死亡率,更长的住院时间和更长时间的无otropic 支持相关.
结论:
- 基本的定义显示了高可靠性,用于识别和分类严重的儿童出血的严重程度.
- 建议在临床实践和研究中一致应用BASIC定义.
- 这种标准化的方法可以导致在儿科重症监护中更可靠的出血评估.
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