在患有神经和神经肌肉疾病的儿童中,术后肺炎风险
Alexander J Strzalkowski1, Patrice Melvin1, Sangeeta Mauskar1
1Complex Care, Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
Hospital pediatrics
|November 20, 2024
概括
患有复杂慢性疾病的儿童的术后肺炎 (PoP) 根据医院和手术类型有很大差异. 患有多种并发症的儿童面临着最高的PoP风险,需要进一步研究预防策略.
科学领域:
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 患有神经和神经肌肉复杂慢性疾病 (NNCCC) 的儿童需要进行手术干预.
- 了解与这些程序相关的风险对于患者的治疗结果至关重要.
研究的目的:
- 评估NNCCC儿童手术后肺炎 (PoP) 的患病率,特征和危险因素.
- 分析不同类型的手术,医院和患者并发症的PoP率.
主要方法:
- 追溯分析了45家儿童医院的2016-2020年63,732例住院外科手术.
- 利用国际疾病分类,第10版,临床修改代码在手术后7天内识别NNCCC和PoP.
- 罗-斯科特基平方试验和估计方程用于根据手术类型,医院和临床特征评估PoP概率.
主要成果:
- 7天PoP的总体患病率为1.1% (688例),在各医院有显著的差异 (0.4%至3.0%).
- 在骨髓移植 (12.5%),固体器官移植 (8.1%) 和心胸外科手术 (4.5%) 中观察到最高的PoP率.
- 患有四种或以上同时存在的慢性疾病的患者患有PoP的可能性明显更高 (OR 10.69).
结论:
- 在患有NNCCC的儿童中,PoP存在显著的变异性,受医院和手术程序的影响.
- 患有多病症的儿童有明显增加的POP风险.
- 进一步的研究是必不可少的,以制定策略,以减轻这种脆弱的儿科群体中PoP风险.
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