体重指数类别与住院儿童不良事件。

Body Mass Index Category and Adverse Events in Hospitalized Children.

机构信息

Department of Pediatrics, Wake Forest School of Medicine (EE Halvorson and A Easter), Winston-Salem, NC.

Department of Pediatrics, Sanford Health (DP Thurtle), Bismarck, ND.

出版信息

Acad Pediatr. 2022 Jul;22(5):747-753. doi: 10.1016/j.acap.2021.09.004. Epub 2021 Sep 17.

DOI:10.1016/j.acap.2021.09.004

PMID:34543672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11716279/

Abstract

OBJECTIVE

To identify associations between patient body mass index (BMI) category and adverse event (AE) rate, severity, and preventability in a cohort of children discharged from an academic children's hospital.

METHODS

We identified patients 2 to 17 years old consecutively discharged between June and October 2018. Patient age, sex, height, and weight were used to categorize patients as having underweight, normal weight, overweight, or obesity. We used the Global Assessment of Pediatrics Patient Safety trigger tool to identify AEs, which were scored for harm and preventability. The primary outcome was the rate of AEs; these were compared with Poisson regression. We used multivariable logistic regression to model event preventability.

RESULTS

We reviewed 834 encounters in 680 subjects; 51 (7.5%) had underweight, 367 (54.0%) had normal weight, 112 (16.5%) had overweight, and 150 (22.1%) had obesity. Our cohort experienced 270 AEs, with an overall rate of 69.7 (61.8-78.5) AEs per 1000 patient-days: 67.7 (46.4-98.7) in underweight, 70.0 (59.4-82.4) in normal weight, 58.6 (42.5-79.7) in overweight, and 80.4 (62.5-103.6) in obesity, P = .46. No associations were seen between BMI category and AE severity. Children with obesity had an increased rate of preventable AEs (P < .01), but this association did not persist in the multivariable model.

CONCLUSIONS

In this single-center study, we did not find associations between BMI category and rate, severity, or preventability of AEs.

摘要

目的

在一家学术儿童医院出院的儿童队列中，确定患者体重指数（BMI）类别与不良事件（AE）发生率、严重程度和可预防之间的关联。

方法

我们连续纳入 2018 年 6 月至 10 月间出院的 2 至 17 岁患者。患者的年龄、性别、身高和体重用于将患者归类为体重不足、正常体重、超重或肥胖。我们使用儿科患者安全全球评估触发工具来识别 AE，并对伤害和可预防程度进行评分。主要结局是 AE 发生率；采用泊松回归进行比较。我们使用多变量逻辑回归模型来预测事件的可预防程度。

结果

我们回顾了 680 名患者中的 834 次就诊，其中 51 名（7.5%）体重不足，367 名（54.0%）体重正常，112 名（16.5%）超重，150 名（22.1%）肥胖。我们的队列发生了 270 例 AE，总体发生率为每 1000 患者日 69.7（61.8-78.5）例：体重不足患者为 67.7（46.4-98.7）例，体重正常患者为 70.0（59.4-82.4）例，超重患者为 58.6（42.5-79.7）例，肥胖患者为 80.4（62.5-103.6）例，P 值为.46。BMI 类别与 AE 严重程度之间未见关联。肥胖儿童 AE 的发生率更高（P <.01），但这种关联在多变量模型中并不存在。