Department of Pediatrics, Division of Adolescent Medicine, University of Utah, Salt Lake City, Utah.
Department of Pediatrics, Division of General Pediatrics, University of Utah, Salt Lake City, Utah.
Acad Pediatr. 2018 Mar;18(2):196-199. doi: 10.1016/j.acap.2017.11.006. Epub 2017 Nov 24.
To determine whether the 2011 guidelines for universal routine screening for dyslipidemia in children aged 9 to 11 years, published by the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents and National Heart, Lung, and Blood Institute, are being followed by pediatric primary-care providers.
Retrospective data were obtained for 63,951 well-child visits (WCV) in children aged 9 to 11 years from 2 health care systems and 1 insurance program from 2009 to 2015. The proportion of WCV that had a lipid panel or total cholesterol test performed within 1 year of the visit was compared for 2009-2011 versus 2013-2015. Associations between demographic variables and lipid screening were evaluated with logistic regression. The frequency of tested children who had abnormal lipid results was evaluated.
Only 3.5% of 9- to 11-year WCV had lipid tests performed in association with the visit before and after the guidelines. Of those tested, 43% had an abnormal lipid result.
Utah clinicians rarely follow guidelines for universal lipid screening of children aged 9 to 11. This represents a missed opportunity to identify children at risk for early-onset cardiovascular disease.
确定儿童青少年心血管健康和风险降低综合指南专家组和美国国家心肺血液研究所发布的针对 9 至 11 岁儿童血脂异常的普遍常规筛查 2011 年指南是否被儿科初级保健提供者遵循。
从 2009 年至 2015 年,从 2 个医疗保健系统和 1 个保险计划中获取了 63951 名 9 至 11 岁儿童的常规儿童健康检查(WCV)的回顾性数据。比较了 2009-2011 年和 2013-2015 年每年有多少 WCV 在就诊后 1 年内进行了血脂检查。使用逻辑回归评估了人口统计学变量与血脂筛查之间的关联。评估了进行过血脂检查的儿童中异常血脂结果的频率。
在指南发布之前和之后,仅有 3.5%的 9 至 11 岁 WCV 进行了血脂检测。在接受检测的儿童中,有 43%的儿童血脂异常。
犹他州的临床医生很少遵循针对 9 至 11 岁儿童普遍血脂筛查的指南。这代表了一个错失的机会,无法识别出早期患心血管疾病风险的儿童。