对于患有复杂肺炎的儿童,需要进行胸腔切除术的胸部X射线图使用的变化
Michelle Polich1,2, Melissa Cameron1,2, Christiane Lenzen1,2
1Division of Pediatric Hospital Medicine, Rady Children's Health San Diego, San Diego, California.
Hospital pediatrics
|November 9, 2025
概括
常规的胸部放射 (CXRs) 在需要胸部管的肺炎患者的医院中存在很大差异. 高CXR使用的医院增加了成本,但没有观察到并发症或停留时间的差异.
科学领域:
- 儿科重症监护 儿科重症监护
- 胸部外科手术 胸部外科手术
- 放射学 放射学是一门学科.
背景情况:
- 在儿童中复杂的肺炎往往需要胸腔管进行管理.
- 胸部放射 (CXR) 经常用于监测这些患者.
- 怀疑医院之间CXR订购实践的显著差异.
研究的目的:
- 为了评估CXR订单频率的变化,对于患有复杂的肺炎的儿科患者,需要胸腔管.
- 评估CXR订购率与患者结果之间的关联,包括并发症,停留时间,费用和再入院.
主要方法:
- 利用儿科健康信息系统 (PHIS) 数据库,为6个月至18岁的患有复杂性肺炎的儿童进行胸腔切除 (2019年7月至2023年6月).
- 计算了每次遇到的每日CXR的比例,以各种因素进行调整.
- 医院根据其每日CXR中位数排序比例分为四分位数,以比较调整后的结果.
主要成果:
- 总共有1817名儿童被纳入;所有遭遇的中位数每日CXR比例为0.68.
- 医院水平中位数调整后的每日CXR比例从0.30到0.91.9不等.
- 在CXR使用四分位数中,肺胸,重复胸口切除,胸口切除后的天数,停留时间或30天的再入院没有发现显著差异.
- 拥有较高CXR使用率的医院显示相关成本显著上升.
结论:
- 对于患有复杂的肺炎,需要胸腔管的儿科患者,订购胸部放射图的频率存在实质性的差异.
- 较高的CXR订购率与增加的医院费用有关,但没有改善关键患者的治疗结果.
- 需要进一步的研究来确定影响胸管并发症的临床因素,并指导最佳的CXR排序策略.
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