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1999年至2008年期间儿科患者因肾绞痛前往急诊科就诊的人数增加。

Rise in emergency department visits of pediatric patients for renal colic from 1999 to 2008.

作者信息

Kairam Neeraja, Allegra John R, Eskin Barnet

机构信息

Morristown Medical Center Residency in Emergency Medicine, Morristown, NJ, USA.

出版信息

Pediatr Emerg Care. 2013 Apr;29(4):462-4. doi: 10.1097/PEC.0b013e31828a302b.

Abstract

OBJECTIVE

Renal colic has been considered predominantly a disease of adults with only occasional cases occurring in the pediatric population. A recent report from a single hospital showed a rise in the number of children with renal colic. Our objective was to examine this in a much larger multihospital database of emergency department (ED) visits.

METHODS

This study has a retrospective cohort design. It was conducted on consecutive pediatric patients (age <18 years) with a diagnosis of "renal colic, calculus kidney, calculus ureter, urinary calculus, or urethral calculus" according to the International Classification of Diseases, Ninth Revision, as seen by ED physicians in 29 urban, suburban, and rural EDs in New Jersey and New York between January 1, 1999, and December 31, 2008. We analyzed the number of renal colic visits as a percent of total ED pediatric visits in yearly intervals using the Student t test and performed a regression analysis. The α was set at 0.05.

RESULTS

The database contained 6,497,458 total ED visits, of which 1,312,487 (20%) were pediatric visits. Of these, 1005 (0.077%) were for renal colic. The median age of these pediatric patients was 16 years (interquartile range, 13-17 years) and 61% were female. The percentage of ED pediatric visits for renal colic increased from 0.048% in 1999 to 0.089% in 2008, an increase of 86% (95% confidence interval, 36%-154%; P < 0.001). The correlation coefficient for this upward trend was R2 = 0.69 (P = 0.003).

CONCLUSIONS

We found a marked increase in ED pediatric visits for renal colic over the past decade. This may reflect a real increase in the incidence of renal colic in the pediatric population or an increased use of imaging modalities for abdominal and flank pain.

摘要

目的

肾绞痛一直被认为主要是成人疾病,儿科患者中仅偶尔出现病例。一家医院最近的报告显示,患肾绞痛的儿童数量有所增加。我们的目的是在一个规模大得多的多医院急诊科就诊数据库中对此进行研究。

方法

本研究采用回顾性队列设计。研究对象为1999年1月1日至2008年12月31日期间在新泽西州和纽约州29家城市、郊区和农村急诊科就诊的连续儿科患者(年龄<18岁),这些患者根据《国际疾病分类》第九版被诊断为“肾绞痛、肾结石、输尿管结石、尿路结石或尿道结石”。我们使用学生t检验分析每年肾绞痛就诊次数占儿科急诊总就诊次数的百分比,并进行回归分析。α设定为0.05。

结果

该数据库包含6497458次急诊总就诊记录,其中1312487次(20%)为儿科就诊记录。其中,1005次(0.077%)是因肾绞痛就诊。这些儿科患者的中位年龄为16岁(四分位间距为13 - 17岁),61%为女性。儿科急诊因肾绞痛就诊的百分比从1999年的0.048%增至2008年的0.089%,增长了86%(95%置信区间为36% - 154%;P < 0.001)。这种上升趋势的相关系数为R2 = 0.69(P = 0.003)。

结论

我们发现过去十年中儿科急诊因肾绞痛就诊的次数显著增加。这可能反映了儿科人群中肾绞痛发病率的实际增加,或者是腹部和侧腹疼痛的成像检查手段使用增多。

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