Center for Injury Research and Policy, The Research Institute, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio 43205, USA.
J Trauma Acute Care Surg. 2013 Aug;75(2):250-7. doi: 10.1097/TA.0b013e3182930fb7.
Chronic conditions influence the outcomes of adult trauma patients, but no study has investigated the impact of chronic conditions among pediatric trauma patients.
We performed a retrospective study using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) to determine the prevalence of chronic conditions among pediatric trauma patients (ages 1-15 years) and to assess the impact of chronic conditions on care resource use and patient mortality.
According to the 2009 KID, an estimated 22,965 or 24.6% of US pediatric trauma patients had preexisting chronic conditions. The most common chronic conditions were mental disorders (7.8%), diseases of the respiratory system (7.7%), and diseases of the nervous system and sensory organs (6.3%). Compared with pediatric trauma patients without chronic conditions, patients with chronic conditions had a longer average stay in the hospital of 5.2 days (95% confidence interval [CI], 4.8-5.5) versus 2.5 days (95% CI, 2.4-2.6). They also had higher hospital charges of $50,815 (95% CI, $47,126-$54,503) versus $23,655 (95% CI, $22,242-$25,067) and a higher mortality rate of 2.6% (95% CI, 2.3-2.9%) versus 0.1% (95% CI, 0.1-0.1%).
Nearly one fourth of pediatric trauma patients had preexisting chronic conditions, and their mortality risk was significantly higher. Treatment guidelines and more research in this special group of trauma patients are warranted.
慢性疾病会影响成年创伤患者的结局,但尚无研究调查儿童创伤患者的慢性疾病的影响。
我们使用 2009 年医疗保健成本和利用项目儿童住院数据库(KID)进行了一项回顾性研究,以确定儿童创伤患者(1-15 岁)中慢性疾病的患病率,并评估慢性疾病对医疗资源利用和患者死亡率的影响。
根据 2009 年 KID 的数据,估计有 22965 名或 24.6%的美国儿科创伤患者存在先前存在的慢性疾病。最常见的慢性疾病是精神障碍(7.8%)、呼吸系统疾病(7.7%)和神经系统及感觉器官疾病(6.3%)。与无慢性疾病的儿科创伤患者相比,患有慢性疾病的患者在医院的平均停留时间长 5.2 天(95%置信区间[CI],4.8-5.5),而非 2.5 天(95%CI,2.4-2.6)。他们的住院费用也更高,为 50815 美元(95%CI,47126-54503),而非 23655 美元(95%CI,22242-25067),死亡率也更高,为 2.6%(95%CI,2.3-2.9%),而非 0.1%(95%CI,0.1-0.1%)。
近四分之一的儿科创伤患者存在先前存在的慢性疾病,其死亡风险明显更高。需要针对这一特殊创伤患者群体制定治疗指南和开展更多研究。