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快速流感诊断检测的地点会影响儿科急诊科的治疗时间和辅助检测吗?

Does location of rapid influenza diagnostic testing influence treatment time and ancillary testing in a paediatric emergency department?

作者信息

Jacob Ron, White Brent, McCaskill Mary E

机构信息

Emergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Paediatric Emergency Department, Ha'Emek Medical Centre, Afula, Israel.

出版信息

Emerg Med Australas. 2021 Feb;33(1):88-93. doi: 10.1111/1742-6723.13591. Epub 2020 Aug 17.

DOI:10.1111/1742-6723.13591
PMID:32808485
Abstract

OBJECTIVE

Influenza causes a significant burden of disease. Our aim was to assess whether location of rapid influenza diagnostic testing (RIDT) for patients with influenza-like illness (ILI) has an impact on ED treatment time or ancillary testing.

METHODS

This was a retrospective observational study in a tertiary paediatric ED during 2017 influenza season. All patients with ILI were included. Some had RIDT performed (ED bedside or at the laboratory). Primary outcome measure was the correlation of RIDT location to treatment time compared to patients with ILI with no RIDT. Secondary outcome measures were the correlation of RIDT location to ancillary testing and treatment with antibiotics.

RESULTS

A total of 1451 patients with ILI were included. Eighty patients for whom RIDT was performed at the laboratory had a shorter treatment time in the ED when compared to the 215 patients for whom RIDT was performed bedside (2.8 and 3.4 h, respectively; P < 0.0001). However, treatment time was not statistically different when sub-analysed for admitted and discharged patients separately. Overall, patients with ILI and no RIDT had the shortest treatment time in the ED (1.7 h). There was no difference in ancillary testing and treatment with antibiotics between ILI patients for whom RIDT was performed bedside or at the laboratory regardless of admission.

CONCLUSION

Location of RIDT may not have a significant impact on treatment time, ancillary testing and treatment with antibiotics. When RIDT was not performed, patients had the shortest treatment time.

摘要

目的

流感造成了重大的疾病负担。我们的目的是评估对流感样疾病(ILI)患者进行快速流感诊断检测(RIDT)的地点是否会影响急诊科(ED)的治疗时间或辅助检查。

方法

这是一项对2017年流感季节一家三级儿科急诊科进行的回顾性观察研究。纳入了所有ILI患者。部分患者进行了RIDT检测(在急诊科床边或实验室)。主要结局指标是将RIDT检测地点与治疗时间的相关性与未进行RIDT检测的ILI患者进行比较。次要结局指标是RIDT检测地点与辅助检查及抗生素治疗的相关性。

结果

共纳入1451例ILI患者。与215例在床边进行RIDT检测的患者相比,在实验室进行RIDT检测的80例患者在急诊科的治疗时间更短(分别为2.8小时和3.4小时;P<0.0001)。然而,分别对入院和出院患者进行亚分析时,治疗时间在统计学上无差异。总体而言,未进行RIDT检测的ILI患者在急诊科的治疗时间最短(1.7小时)。无论是否入院,在床边或实验室进行RIDT检测的ILI患者在辅助检查和抗生素治疗方面均无差异。

结论

RIDT检测地点可能对治疗时间、辅助检查和抗生素治疗没有显著影响。未进行RIDT检测时,患者的治疗时间最短。

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