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就诊于儿科急诊科的儿科危重症患者的流行病学

Epidemiology of pediatric critically-ill patients presenting to the pediatric emergency department.

作者信息

Yang W-C, Lin Y-R, Zhao L-L, Wu Y-K, Chang Y-J, Chen C-Y, Wu K-H, Wu H-P

机构信息

Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

Klin Padiatr. 2013 Jan;225(1):18-23. doi: 10.1055/s-0032-1331168. Epub 2013 Jan 17.

Abstract

This study aimed to analyze the epidemiologic patterns of pediatric critically-ill patients presenting to the emergency department (ED) and the etiologies of intensive care unit (ICU) admission of different age groups.This retrospective study of all children aged less than 18 years presenting with critical illnesses to the ED was conducted in a tertiary medical center in Taiwan from 2003 to 2007. All patients transferred to the ICU from the ED were included without distinction. Demographic data of critically-ill children admitted to the ED and ICU were analyzed. Etiologies of the ICU admissions were analyzed by various age groups.There were 2978 critically-ill children admitted to the ICU from the ED. In 120 pediatric patients with out-of-hospital cardiac arrest, cases with pulseless electrical activity or ventricular fibrillation had higher successful CPR rates than patients with asystole (both p<0.05). In patients admitted to ICUs, complications from the perinatal period, respiratory system diseases, accidental injuries and poisoning were the predominant etiologies respectively in young children (42.5%), school-aged children (38.5%), and adolescents (47.9%). Moreover, the most common of which was respiratory distress syndrome in neonates followed by bacterial pneumonia and status epilepticus.Epidemiologic analysis may provide primary clinicians to identify significant differences in admission rates based on different etiologies of various age groups.

摘要

本研究旨在分析急诊科收治的儿科危重症患者的流行病学模式以及不同年龄组入住重症监护病房(ICU)的病因。2003年至2007年,在台湾一家三级医疗中心对所有18岁以下因危重症就诊于急诊科的儿童进行了这项回顾性研究。所有从急诊科转入ICU的患者均被纳入,无差别对待。分析了急诊科和ICU收治的危重症儿童的人口统计学数据。按不同年龄组分析了入住ICU的病因。有2978名危重症儿童从急诊科转入ICU。在120例院外心脏骤停的儿科患者中,无脉电活动或室颤患者的心肺复苏成功率高于心脏停搏患者(均p<0.05)。在入住ICU的患者中,围生期并发症、呼吸系统疾病、意外伤害和中毒分别是幼儿(42.5%)、学龄儿童(38.5%)和青少年(47.9%)入住ICU的主要病因。此外,新生儿中最常见的是呼吸窘迫综合征,其次是细菌性肺炎和癫痫持续状态。流行病学分析可为一线临床医生提供依据,以识别基于不同年龄组不同病因的入院率的显著差异。

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