Wittlieb-Weber Carol A, Rossano Joseph W, Weber David R, Lin Kimberly Y, Ravishankar Chitra, Mascio Christopher E, Shaddy Robert E, O'Connor Matthew J
Division of Pediatric Cardiology, University of Rochester Medical Center, Rochester, NY, USA.
Division of Pediatric Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine and the University of Pennsylvania, Philadelphia, PA, USA.
Pediatr Transplant. 2017 Jun;21(4). doi: 10.1111/petr.12936. Epub 2017 Apr 29.
We used the NEDS database (2010) to evaluate ED utilization in PED HT recipients compared to other patient populations with focus on characteristics of ED visits, risk factors for admission, and charges. We analyzed 433 ED visits by PED HT recipients (median age 8 [range: 0-18] years). The most common primary diagnosis category was infectious (n=163, 37.6%), with pneumonia being the most common infectious etiology. When compared to all PED visits, HT visits were more likely to result in hospital admission (32.6% versus 3.9%, P<.001), had greater hospital LOS (median of 3 days [IQR 2-4] versus 2 days [IQR 1-4], P=.001), and accumulated greater total hospital charges (median $26 317 [IQR $11 438-$46 407] versus $12 332 [IQR $7092-$22 583], P<.001). When compared to visits by other SOT recipients, results varied with similar rates of hospital admission for HT, LUNGT, and KT visits and similar LOS for HT and KT visits but differing total hospital charges. Although PED HT recipients account for a small percentage of overall ED visits, they are more likely to be hospitalized and require greater resource utilization compared to the general PED population, but not when compared to other SOT recipients.
我们使用国家急诊护理数据集（2010年）来评估小儿心脏移植（PED HT）受者与其他患者群体相比的急诊利用情况，重点关注急诊就诊特征、入院风险因素和费用。我们分析了433例小儿心脏移植受者的急诊就诊情况（中位年龄8岁[范围：0 - 18岁]）。最常见的主要诊断类别为感染性疾病（n = 163，37.6%），其中肺炎是最常见的感染病因。与所有小儿急诊就诊相比，心脏移植就诊更有可能导致住院（32.6%对3.9%，P <.001），住院时间更长（中位3天[四分位间距2 - 4天]对2天[四分位间距1 - 4天]，P =.001），且累计的总住院费用更高（中位26317美元[四分位间距11438 - 46407美元]对12332美元[四分位间距7092 - 22583美元]，P <.001）。与其他实体器官移植受者的就诊情况相比，结果有所不同，心脏移植、肺移植和肾移植就诊的住院率相似，心脏移植和肾移植就诊的住院时间相似，但总住院费用不同。尽管小儿心脏移植受者在急诊就诊总数中占比很小，但与普通小儿急诊人群相比，他们更有可能住院且需要更多资源利用，但与其他实体器官移植受者相比则不然。
