儿科患者药物处方和气管管切除术后结果的差异
Pooja D Reddy1, Akshaya Raman1, Soukaina Eljamri1
1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
The Annals of otology, rhinology, and laryngology
|January 2, 2025
概括
种族和保险等社会决定因素影响儿科气管切除术护理,影响抗生素处方和结果. 解决这些差异对于公平和优化患者护理至关重要.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 儿科气管切除术与诸如颗粒组织形成和气管炎等并发症有关.
- 氨酸/甲胺是一种常见的治疗方法,但健康的社会决定因素 (SDOH) 在其处方和患者结果中的作用尚不清楚.
研究的目的:
- 调查SDOH的影响,包括种族,保险状况和区域贫困指数 (ADI),对儿童患者的西普罗夫洛克萨/德克萨的处方和气管切除术后的结果.
- 识别与社会因素相关的护理和结果的差异.
主要方法:
- 在一个学术机构对182名儿科气管切除术患者 (2016-2020年) 的回顾性队列研究.
- 分析社会决定因素 (种族,保险,ADI) 以及它们与药物处方和结果的关联,使用后勤回归,威尔科克森等级和日志等级测试.
主要成果:
- 非白人种族与接受 nebulized ciprofloxacin/dexamethasone (OR=2.80) 的几率增加有关.
- 在气管培养物中,公共保险与金黄色葡萄球菌 (包括MRSA) 的更高率有关 (OR=3.54).
- 较高的ADI与Streptococcus pneumoniae的存在和特定的包装选择相关. 气管炎与生活在离中心更远的地方有关,抗生素耐药性在出院的儿童中更为普遍,与更长的住院时间相关. 非白人患者的脱率更高 (HR=2.85).
结论:
- 在儿童气管切除术中使用西普罗夫洛克萨/德克萨存在种族差异.
- 气管培养结果和穿衣选择的差异与居住相关的因素和ADI有关.
- 定制和公平的护理策略是必要的,以优化所有儿科气管切除术患者的结果.
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