在日本的ICU和普通病房治疗机械通风儿童的患者背景和结果:使用国家住院患者数据库进行回顾性队列研究
Yoshio Sakurai1, Nobuaki Michihata2, Kohei Osada1
1Department of Pediatric Critical Care Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Critical care medicine
|October 17, 2025
概括
在日本,大多数需要机械通风的儿童都在普通病房接受治疗,而不是重症监护室 (ICU). 这项研究发现,与ICU相比,一般病房的机械通风的儿科患者的住院死亡率更高.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
- 住院护理管理 住院护理管理
背景情况:
- 机械通风是西方国家的重症成人和儿科患者的标准护理,通常在重症监护室 (ICU) 进行.
- 在日本,人们对在一般医院病房而不是ICU治疗需要机械通风的儿科患者的做法存在担忧.
- 这种差异需要对患者的特征和治疗结果进行调查.
研究的目的:
- 为了比较一般病房和日本ICU机械通风儿童的患者特征和治疗结果.
- 评估治疗地点对需要机械通风的儿科患者住院死亡率的影响.
主要方法:
- 一项回顾性队列研究,利用日本国家住院患者数据库 (2010年7月 - 2022年3月).
- 包括129,375名14岁或更年轻的机械通风儿童.
- 使用1:1倾向分数匹配来比较一般病房和ICU队列之间的住院死亡率.
主要成果:
- 在机械呼吸的儿童中,很大一部分 (63%的整体,78%的非手术,17%的术后) 在一般病房接受治疗.
- 重症监护病房患者主要是术后 (56%),70%接受心脏手术.
- 15,760对的倾向性得分匹配显示,与ICU相比,一般病房的住院死亡率 (6.4%) 显著更高 (4.1%; OR, 1.49; p < 0.001).
结论:
- 在日本,大多数需要机械通风的儿科患者在普通病房接受护理.
- 与重症监护室相比,一般病房的治疗与医院内死亡率的增加有关.
- 建议在ICU中集中照顾机械通风的儿科患者,以改善结果.
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