儿童医院在 COVID-19 大流行期间的安全事件。

Safety Events in Children's Hospitals During the COVID-19 Pandemic.

机构信息

Department of Pediatrics, Children's Mercy Hospital and University of Missouri-Kansas City, Kansas City, Missouri;

Children's Hospital Association, Lenexa, Kansas.

出版信息

Hosp Pediatr. 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937. Epub 2021 May 6.

DOI:10.1542/hpeds.2020-004937

PMID:33958441

Abstract

BACKGROUND AND OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. Our objective was to compare pediatric hospitalization safety events during the pandemic versus previous years.

METHODS

In this retrospective cohort study of hospitalizations in the Pediatric Health Information System, we compared Pediatric Quality Indicator (PDI) rates from March 15 to May 31, 2017-2019 (pre-COVID-19), with those from March 15 to May 31, 2020 (during COVID-19). Generalized linear mixed-effects models with adjustment for patient characteristics (eg, diagnosis, clinical severity) were used.

RESULTS

There were 399 113 discharges pre-COVID-19 and 88 140 during COVID-19. Unadjusted PDI rates were higher during versus pre-COVID-19 for overall PDIs (6.39 vs 5.05; < .001). In adjusted analyses, odds of postoperative sepsis were higher during COVID-19 versus pre-COVID-19 (adjusted odds ratio 1.28 [95% confidence interval 1.04-1.56]). The remainder of the PDIs did not have increased adjusted odds during compared with pre-COVID-19.

CONCLUSIONS

Postoperative sepsis rates increased among children hospitalized during COVID-19. Efforts are needed to improve safety of postoperative care for hospitalized children.

摘要

背景与目的

2019 年冠状病毒病（COVID-19）大流行对医院造成了影响，可能会影响医疗质量和安全。我们的目的是比较 COVID-19 大流行期间和前几年儿科住院安全事件的发生情况。

方法

本研究为回顾性队列研究，利用儿科健康信息系统中的住院患者数据，我们比较了 2017 年至 2019 年 3 月 15 日至 5 月 31 日（COVID-19 前）和 2020 年 3 月 15 日至 5 月 31 日（COVID-19 期间）的儿科质量指标（PDI）发生率。采用调整患者特征（如诊断、临床严重程度）的广义线性混合效应模型进行分析。

结果

COVID-19 前有 399113 例出院，COVID-19 期间有 88140 例。未校正的 PDI 发生率在 COVID-19 期间高于 COVID-19 前，总体 PDI 为 6.39 比 5.05（<0.001）。在调整分析中，COVID-19 期间术后脓毒症的发生风险高于 COVID-19 前（调整后比值比 1.28 [95%置信区间 1.04-1.56]）。与 COVID-19 前相比，其他 PDI 在调整后发生风险并未增加。