Intensive Care Unit, Children's Clinical University Hospital, Riga, Latvia.
Department of Clinical Skills and Medical Technology, Riga Stradiņš University, Riga, Latvia.
Pediatr Crit Care Med. 2020 May;21(5):e213-e220. doi: 10.1097/PCC.0000000000002255.
Pediatric mortality in Latvia remains one of the highest among Europe. The purpose of this study was to assess the quality of pediatric acute care and pediatric readiness and determine their association with patient outcomes using a patient registry.
This was a prospective cohort study. Pediatric readiness was measured using the weighted pediatric readiness score based on a 100-point scale. The processes of care were measured using in situ simulations to generate a composite quality score. Clinical outcome data-including PICU and hospital length of stay as well as 6-month mortality-were collected from the Pediatric Intensive Care Audit Network registry. The associations between composite quality score and weighted pediatric readiness score on patient outcomes were explored with mixed-effects regressions.
This study was conducted in all Latvian Emergency Departments and in the national PICU.
All patients who were transferred into the national PICU were included.
None.
All (16/16) Latvian Emergency Departments participated with a mean composite quality score of 35.3 of 100 and a median weighted pediatric readiness score of 31 of 100. A total of 254 patients were included in the study and followed up for a mean of 436 days, of which nine died (3.5%). Higher weighted pediatric readiness score was associated significantly with lower length of stay in both the PICU and hospital (adjusted ß, -0.06; p = 0.021 and -0.36; p = 0.011, respectively) and lower 6-month mortality (adjusted odds ratio, 0.93; 95% CI, 0.88-0.98).
These data provide a national assessment of pediatric emergency care in a European country. Pediatric readiness in the emergency department was associated with patient outcomes in this population of pediatric patients transferred to the national PICU.
拉脱维亚的儿科死亡率仍然是欧洲最高的国家之一。本研究的目的是评估儿科急症护理质量和儿科准备情况，并使用患者登记处确定它们与患者结局的关系。
这是一项前瞻性队列研究。儿科准备情况使用基于 100 分制的加权儿科准备评分进行衡量。使用现场模拟来衡量护理过程，以生成综合质量评分。从儿科重症监护审核网络登记处收集临床结局数据，包括儿科重症监护病房和医院的住院时间以及 6 个月的死亡率。使用混合效应回归探讨复合质量评分与患者结局的加权儿科准备评分之间的关系。
本研究在所有拉脱维亚急诊室和国家儿科重症监护病房进行。
所有转入国家儿科重症监护病房的患者均被纳入研究。
无。
所有（16/16）拉脱维亚急诊室均参与研究，平均综合质量评分为 35.3/100，加权儿科准备评分为 31/100。共有 254 名患者纳入研究并随访平均 436 天，其中 9 人死亡（3.5%）。较高的加权儿科准备评分与儿科重症监护病房和医院的住院时间均较短相关（调整后的β，-0.06；p=0.021 和-0.36；p=0.011），6 个月死亡率也较低（调整后的优势比，0.93；95%CI，0.88-0.98）。
这些数据提供了欧洲国家儿科急症护理的全国评估。在将患者转入国家儿科重症监护病房的人群中，急诊室的儿科准备情况与患者结局相关。
