Children's Hospital of Wisconsin, Milwaukee, Wisconsin; and.
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Hosp Pediatr. 2021 Feb;11(2):160-166. doi: 10.1542/hpeds.2020-0083.
To characterize the patient population of adolescents hospitalized at a tertiary center for ingestions and identify opportunities to improve health care delivered and resources offered to these adolescents.
Retrospective study of a consecutive sample of adolescent patients (12-18 years old) discharged from the hospitalist service at a large academic pediatric tertiary care center from May 2017 through April 2018. Data were collected regarding patient and hospital encounter characteristics including length of stay, admission service, reason for ingestion, substance(s) ingested, previous suicidal ideation (SI) screening, sexual history documentation, pregnancy testing, disposition at discharge and follow-up with primary care physicians (PCPs).
Most hospitalizations for ingestions were reported as intentional suicide attempts (79%). Most commonly, adolescents ingested exclusively prescription medications (45%) or over-the-counter medications (32%). Of adolescents with a reported suicide attempt for whom PCP records were available, 56% did not have SI screening documented in the medical record. One-quarter of adolescents hospitalized for an ingestion did not have a sexual history documented, and 11% of female patients were not tested for pregnancy before discharge. A majority (66%) of the adolescents with PCP records available did not follow-up with their PCP within 2 months after their hospitalization.
On the basis of our study results, opportunities to improve adolescent health include increased screening for SI and mental health symptoms throughout medical environments, comprehensive risk assessment of all adolescents hospitalized for an ingestion and increased guidance for caregivers of adolescents regarding prescription and over-the-counter medication storage in the home.
描述在一家三级中心因摄入而住院的青少年患者人群，并确定改善向这些青少年提供的医疗服务和资源的机会。
对 2017 年 5 月至 2018 年 4 月期间从一家大型学术儿科三级保健中心的住院医师服务出院的连续样本中的青少年患者（12-18 岁）进行回顾性研究。收集了有关患者和医院就诊特征的数据，包括住院时间、入院服务、摄入原因、摄入物质、以前的自杀意念（SI）筛查、性史记录、妊娠检测、出院处置和与初级保健医生（PCP）的随访。
大多数因摄入而住院的情况被报告为故意自杀企图（79%）。最常见的是，青少年仅摄入处方药物（45%）或非处方药物（32%）。在有报告自杀企图的青少年中，有 56%的人在医疗记录中没有记录 SI 筛查。四分之一因摄入而住院的青少年没有记录性史，11%的女性患者在出院前没有进行妊娠检测。有 66%的有 PCP 记录可查的青少年在住院后 2 个月内没有与 PCP 随访。
根据我们的研究结果，改善青少年健康的机会包括在整个医疗环境中增加对 SI 和心理健康症状的筛查、对所有因摄入而住院的青少年进行全面风险评估以及增加对青少年的看护人关于家庭中储存处方药和非处方药的指导。
