开发儿科Crotalid中毒评分指南及其对资源利用的影响
Adil J Malek1, Anthony A Criscitiello2, Emily K Nes2
1General and Endocrine Surgery, Brookwood Baptist Health Residency, 3686 Grandview Parkway, Birmingham, AL 35243, USA.
Journal of pediatric surgery
|August 14, 2025
概括
对于儿科蛇咬伤的新指导方针显著减少了重症监护室 (ICU) 的入院和停留时间. 这种特定于儿科的方法节约了资源,同时保持了优秀的患者结果.
科学领域:
- 儿科急救医学 儿科急救医学
- 毒理学 毒理学 毒理学
- 临床指南开发 临床指南开发
背景情况:
- 儿童类蛇咬伤导致显著的发病率.
- 目前的管理协议不是针对儿科的,这导致了昂贵的重症监护室 (ICU) 住院和抗毒药的使用.
研究的目的:
- 评估新实施的儿科特定的蛇治疗指南对患者结果和资源利用的影响.
- 评估儿科虫中毒评分 (CES) 准则在治疗儿科虫中毒的有效性.
主要方法:
- 使用回顾性数据 (2008-2018) 开发儿科虫毒性评分 (CES) 准则.
- 以后向三个类别进行分类 (CES 0,1,2),以指导入院和抗毒剂剂量.
- 预期数据收集 (2019-2022) 和对准则前后队列对ICU入院,ICU停留时间 (LOS),抗毒药瓶,医院LOS,再入院和不良反应进行比较.
主要成果:
- 准则后的队列显示了ICU入院的显著减少 (63%与84%相比),ICU LOS减少了66%.
- 通过CES的分层显示,CES 0和CES 1的ICU入院数量大幅减少,CES 0的抗毒瓶数量减少.
- 医院LOS,再入院和不良反应在队列之间仍然相似.
结论:
- 儿科虫中毒评分指南有效地节约了医疗保健资源.
- 该指南保持了儿童类蛇咬的优秀患者结果.
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