儿童尾炎的手术延迟:社会脆弱性的作用
Villa-Aguilar Estefany1, Marín-Morales Karen1, Ayala-Galvan Citlali1
1Centro de Investigación Traslacional, Instituto Nacional de Pediatría, Mexico City, Mexico.
Frontiers in pediatrics
|July 17, 2025
概括
儿童尾炎的手术治疗延迟,尤其是在没有保险的儿童中,会导致复杂尾炎 (CA). 社会脆弱性显著增加了CA的风险,强调了需要解决及时治疗的医疗和社会因素.
科学领域:
- 儿科手术 儿科手术
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尾炎是一种常见的儿科手术紧急情况,经常被用作及时护理的质量指标.
- 复杂尾炎 (CA) 发病率仍然很高,这是由于儿科手术护理的延迟造成的.
- 社会脆弱性与手术接入有关,特别是在低收入和中等收入人群中.
研究的目的:
- 检查墨西哥没有社会保障的儿童手术延迟和复杂尾炎的社会决定因素之间的关系.
- 确定导致尾炎儿科手术护理延迟的因素.
主要方法:
- 在公立医院对943例儿科尾炎病例 (2018-2021) 的回顾性队列研究.
- 主要结局:尾炎类型 (急性/复杂). 独立变量:进化时间和社会经济因素.
- 后勤回归分析,以评估尾炎类型和共变量之间的关系.
主要成果:
- 62.67%的儿科尾炎病例呈现为复杂尾炎 (CA).
- 前入院延迟 (≥48小时) 与CA的几率显著增加有关 (OR 3.27).
- 5岁以下的儿童也有更高的CA几率 (OR 1.76).
结论:
- 在没有保险的儿童中,高CA率与手术延迟超过两天有关.
- 社会脆弱性阻碍了获得优质儿科外科护理的机会.
- 尾炎必须被视为医疗和社会问题,需要全面的战略来解决健康的社会决定因素.
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