社区发病的儿科状态:在现实世界中护理障碍和结果的障碍
Anna Fetta1,2, Luca Bergonzini1,2, Arianna Dondi3
1U.O.C. Neuropsichiatria dell'età Pediatrica, Member of the ERN EpiCare, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
有效的医院前救援药物管理和及时的儿科急诊室 (PED) 管理对于减少儿科状态 (SE) 的持续时间和改善结果至关重要. 识别护理障碍对于改善患者的治疗结果至关重要.
科学领域:
- 儿科神经学 儿科神经学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 状态 (SE) 是一个危急的儿科神经紧急情况,可能会产生长期后果.
- 儿科SE的管理包括医院前和医院内阶段,每个阶段都有潜在的挑战.
- 预测评分系统用于评估SE的严重程度和结果.
研究的目的:
- 确定社区发病儿科SE.在医院前和医院内管理的障碍.
- 评估儿科分数在预测儿科SE.结果方面的有效性.
- 分析影响SE持续时间和患者结果的因素.
主要方法:
- 一个单一的,观察性的,对103个儿科SE发作 (2010-2021) 的回顾性队列研究.
- 根据STROBE指南收集的数据,包括医院前,医院内管理和结果.
- 对儿科得分的回顾性评估 (PEWS,STEPSS,PEDSS) 为了结果预测的准确性.
主要成果:
- 医院以外的救援药物使用与在入院前更高的SE解决率有关.
- 在儿科急诊室 (PED) 开始治疗的延迟与更长的SE持续时间相关.
- 预测得分的准确性各不相同;PEWS ≥5具有高灵敏度,但对ICU入院的特异性较低.
结论:
- 及时的医院前和医院内干预对于减少儿科SE持续时间和改善结果至关重要.
- 虽然预测分数可以帮助SE评估,但它们的最终实用性需要进一步定义.
- 解决SE管理途径中发现的护理障碍对于优化儿科患者的治疗结果至关重要.
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