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已确诊支气管肺发育不良患者延迟转诊的院内转归。

In-hospital outcomes of late referrals for established bronchopulmonary dysplasia.

机构信息

Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, USA.

Division of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA.

出版信息

J Perinatol. 2021 Aug;41(8):1972-1982. doi: 10.1038/s41372-021-01041-6. Epub 2021 Mar 23.

Abstract

OBJECTIVE

To determine the in-hospital outcomes for patients with established bronchopulmonary dysplasia (BPD) referred late for severe disease.

STUDY DESIGN

Retrospective cohort study of patients with established BPD referred to our center after 36 weeks PMA.

RESULT

Among 71 patients with BPD referred to our center after 36 weeks PMA between 2010 and 2018, the median PMA was 47 weeks (IQR, 42, 53) and the median respiratory severity score was 8.1 (IQR 4.5, 11.0) on admission. Survival in this cohort was 92%. Most survivors were discharged home without the need for positive pressure respiratory support (77%) or pulmonary vasodilators (89%). For survivors, we observed a significant improvement in median z-scores for length (-6.7 vs -3.3, p < 0.0001) between admission and discharge.

CONCLUSION

Despite presenting relatively late with a high degree of illness severity, nearly all patients in this cohort survived to hospital discharge with improvement in comorbidities.

摘要

目的

确定已确诊支气管肺发育不良(BPD)患者在疾病严重时延迟就诊的住院结局。

研究设计

回顾性队列研究,纳入在胎龄 36 周后转诊至本中心的已确诊 BPD 患者。

结果

在 2010 年至 2018 年间转诊至本中心的 71 例胎龄 36 周后 BPD 患者中,中位胎龄为 47 周(IQR,42,53),入院时中位呼吸严重程度评分为 8.1(IQR,4.5,11.0)。该队列的存活率为 92%。大多数幸存者无需正压通气支持(77%)或肺血管扩张剂(89%)即可出院回家。对于幸存者,我们观察到入院时和出院时的长度 Z 评分中位数(-6.7 比-3.3,p < 0.0001)有显著改善。

结论

尽管该队列的患者就诊时疾病严重程度相对较高,但就诊较晚,几乎所有患者都存活至出院,合并症得到改善。

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