Kampfschulte Andrew, Oram Matthew, Escobar Vasco Alejandra M, Essenmacher Brittany, Herbig Amy, Behere Aniruddh, Leimanis-Laurens Mara L, Rajasekaran Surender
Office of Research and Education, Spectrum Health, 15 Michigan Street NE, Grand Rapids, MI 49503, USA.
Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824, USA.
Children (Basel). 2021 Jan 20;8(2):59. doi: 10.3390/children8020059.
Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; = 0.0013), and presented in summer months (OR: 1.51, = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.
在过去十年中，一些儿科年龄组的自杀频率增加了两倍，其中严重的自杀未遂导致患儿入住儿科重症监护病房（PICU）。我们将临床、总体地理空间和时间人口统计学数据相结合，以了解当地社区变量，从而确定是否出现与入住PICU风险相关的流行病学模式。通过与自杀相关的国际疾病分类第十版（ICD - 10）编码，于2011年1月至2017年12月在一家城市的高容量四级医疗设施中提取数据。对临床、社会经济、地理和时间变量进行了审查。总共纳入了1036名9岁以上的患者，其中161名入住了PICU。在所有与自杀相关的住院患者中，女性占比更高（67.9%）。从种族/民族来看，入住PICU的患者主要是白种人（83.2%）；黑人和西班牙裔入住PICU的几率较低（分别为OR：0.49；0.17）。入住PICU的患者年龄更大（16.0岁对15.5岁；P = 0.0001），基础代谢指数更低（23.0对22.0；P = 0.0013），且多在夏季就诊（OR：1.51，P = 0.044）。时间序列分解显示6月和8月出现季节性高峰。城市界限以外的局部地区发现有更多患者入住PICU。PICU服务于特定的地理区域，并且与临床地理空间/季节分析相结合时，是一个信息来源，突出了与入住PICU相关的临床和社会风险因素。
