在儿童医院的喘恶化系统性皮质类固醇处方的变化
Siân Best1,2, Matt Hall1,3, Jessica L Bettenhausen1,2
1Division of Hospital Medicine, Children's Mercy Kansas City, Kansas City, Missouri.
Hospital pediatrics
|December 1, 2025
概括
儿童喘住院治疗的系统性皮质类固醇处方显示了甲使用量的增加. 医院一级的处方模式各不相同,但较高的德甲使用量与不同的住院结果没有相关性.
科学领域:
- 儿科肺病学 儿科肺病学
- 医院质量改善 医院质量改善
- 药物治疗研究 药物治疗研究
背景情况:
- 喘恶化是儿童住院的主要原因,系统性皮质类固醇作为标准治疗.
- 医院在急性喘期间如何处方这些关键药物存在显著的变化.
- 了解处方趋势及其对患者结果的影响对于优化护理至关重要.
研究的目的:
- 分析儿童喘住院患者系统性皮质类固醇处方的趋势和医院级变化.
- 调查医院级德甲使用与关键住院结果之间的关联.
- 确定急性喘恶化治疗方案的潜在改进.
主要方法:
- 从2016-2023年使用儿科健康信息系统数据库对122,856例儿科喘住院病例 (年龄在2-18岁) 的回顾性分析.
- 检查了德克萨米他,普得尼松,普得尼索隆和甲基普得尼索隆的处方趋势.
- 用通用估计方程来评估每年在医院使用德甲和住院时间,ED复诊和再入院率之间的联系,控制临床和人口因素.
主要成果:
- 在38家儿童医院中,德克萨米他的使用量显著增加,从2016年的42%增加到2023年的77%.
- 在研究期间,超过80%使用德甲的医院比例从18%上升到66%.
- 根据医院级德克萨米他处方率,没有发现住院结果 (住院时间,ED复诊,再入院) 的统计学上显著差异.
结论:
- 2016年至2023年间,医院级为儿科喘恶化处方德克萨的处方显著增加.
- 尽管甲的使用增加,但没有观察到与改善或恶化住院结果的关联.
- 这些发现表明,虽然处方模式正在转变,但在医院水平上选择皮质类固醇似乎不会影响关键结果.
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