一项比较两组 ICU 长期住院患儿的研究。
A comparative two-cohort study of pediatric patients with long term stay in ICUs.
机构信息
Pediatric Intensive Care Unit, Gregorio Marañón General University Hospital, 2ª Planta Bloque D, Calle Doctor Castelo 47, 28007, Madrid, Spain.
Department of Maternal and Child and Public Health, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
出版信息
Sci Rep. 2021 Feb 25;11(1):4631. doi: 10.1038/s41598-021-84248-z.
During the last decades, the number of patients with long stay admissions (LSA) in PICU has increased. The purpose of this study was to identify factors associated with PICU LSA, assessing healthcare resources use and changes in the profile of these patients. A retrospective, observational, single-center study was carried out. Characteristics of LSA were compared between two periods (2006-2010 and 2011-2015). During the earlier period there were 2,118 admissions (3.9% of them LSA), whereas during the second period, there were 1,763 (5.4% of them LSA) (p = 0.025). LSA accounted for 33.7% PICU stay days during the first period and 46.7% during the second (p < 0.001). Higher use of non-invasive ventilation (80.2% vs. 37.8%, p = 0.001) and high-flow oxygen therapy (68.8% vs. 37.8%, p = 0.005) was observed in the 2011-2015 cohort, whereas the use of arterial catheter (77.1% vs. 92.6%, p = 0.005), continuous infusion of adrenaline (55.2% vs. 75.9%, p = 0.004), and hemoderivative transfusion (74% vs. 89.2%, p = 0.010) was less frequent. In the 2006-2010 cohort, hospital-acquired infections were more common (95.2% vs. 68.8%, p < 0.001) and mortality was higher (26.8% vs. 13.8%, p = 0.026). The number of long-stay PICU admissions have increased entailing an intensive use of healthcare resources. These patients have a high risk for complications and mortality.
在过去的几十年中，长期留院（LSA）在 PICU 中的患者数量有所增加。本研究的目的是确定与 PICU LSA 相关的因素，评估医疗资源的使用情况，并改变这些患者的特征。进行了一项回顾性、观察性、单中心研究。比较了两个时期（2006-2010 年和 2011-2015 年）LSA 的特征。在早期，有 2118 例住院（其中 3.9%为 LSA），而在第二个时期，有 1763 例（其中 5.4%为 LSA）（p=0.025）。LSA 占第一个时期 PICU 住院天数的 33.7%，占第二个时期的 46.7%（p<0.001）。与 2011-2015 年队列相比，在该队列中观察到非侵入性通气（80.2%比 37.8%，p=0.001）和高流量氧疗（68.8%比 37.8%，p=0.005）的使用更高，而动脉导管的使用（77.1%比 92.6%，p=0.005）、肾上腺素连续输注（55.2%比 75.9%，p=0.004）和血液制品输注（74%比 89.2%，p=0.010）的频率较低。在 2006-2010 年队列中，医院获得性感染更为常见（95.2%比 68.8%，p<0.001），死亡率更高（26.8%比 13.8%，p=0.026）。长期 PICU 住院人数的增加需要大量的医疗资源。这些患者有发生并发症和死亡的高风险。
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