Division of Pediatric Pulmonology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 94143-0106, USA.
Pediatr Pulmonol. 2012 Apr;47(4):409-14. doi: 10.1002/ppul.21536. Epub 2011 Sep 7.
Ventilator-dependent children have complex chronic conditions that put them at risk for acute illness and repeated hospitalizations.
To determine the 12-month incidence of and risk factors for non-elective readmission in children with chronic respiratory failure (CRF) after initiation on home mechanical ventilation (HMV) via tracheostomy.
A retrospective cohort study of 109 HMV patients initiated and followed at an university-affiliated children's hospital between 2003 and 2009. Patient characteristics are presented using descriptive statistics; generalized estimated equations are used to estimate adjusted odds ratios of select predictor variables for readmission.
The 12-month incidence of non-elective readmission was 40%. Close to half of these readmissions occurred within the first 3 months post-index discharge. Pneumonia and tracheitis were the most common reasons for readmission; 64% were pulmonary- or tracheostomy-related. Most demographic and clinical patient characteristics were not statistically associated with non-elective readmissions. Although, a change in the child's management within 7 days before discharge was associated readmissions shortly after index discharge.
Non-elective readmissions of newly initiated pediatric HMV patients were common and likely multifactorial. Many of these readmissions were airway-related, and some may have been potentially preventable.
依赖呼吸机的儿童患有复杂的慢性疾病，这使他们面临急性疾病和反复住院的风险。
确定经气管切开术在家用机械通气（HMV）启动后慢性呼吸衰竭（CRF）儿童非择期再入院的 12 个月发生率和危险因素。
对 2003 年至 2009 年期间在一所大学附属儿童医院启动和随访的 109 例 HMV 患者进行回顾性队列研究。使用描述性统计数据介绍患者特征；使用广义估计方程估计选择预测变量对再入院的调整比值比。
非择期再入院的 12 个月发生率为 40%。这些再入院中有近一半发生在索引出院后的前 3 个月内。肺炎和气管炎是再入院的最常见原因；64%与肺部或气管切开术相关。大多数人口统计学和临床患者特征与非择期再入院无统计学关联。尽管如此，在索引出院前 7 天内患儿管理方式的改变与索引出院后不久的再入院有关。
新启动的儿科 HMV 患者的非择期再入院很常见，可能是多因素的。这些再入院中有许多与气道有关，其中一些可能是可以预防的。
