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儿科重症监护病房发病率及相关因素分析。

Incidence of morbidity and associated factors in a Pediatric Intensive Care Unit.

机构信息

Servicio de Cuidados Intensivos Pediátricos, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Arch Argent Pediatr. 2021 Dec;119(6):394-400. doi: 10.5546/aap.2021.eng.394.

Abstract

INTRODUCTION

The Functional Status Scale (FSS) was developed to measure acquired morbidity in pediatric patients.

OBJECTIVE

To estimate the incidence of acquired morbidity in the pediatric intensive care unit (PICU) and the presence of associated factors, and describe functional status after hospital discharge.

POPULATION AND METHODS

Prospective cohort. All PICU admissions between August 2016 and July 2017. The FSS was used to measure acquired morbidity during hospitalization and up to 1 year after discharge. A univariate analysis was performed to investigate morbidity-associated factors.

RESULTS

A total of 842 patients were included. The incidence of morbidity at the PICU was 3.56 % (30/842) and persisted at 0.7 % for the entire cohort at hospital discharge (6/842). Within 1 year after discharge, the functional status of 3/6 patients improved. The univariate analysis showed an association between acquired morbidity at the PICU and the PIM2 score (odds ratio [OR]: 1.04; 95 % confidence interval [CI]: 1.01-1.07; p = 0.007), age younger than 1 year (OR: 2.93; 95 % CI: 1.36-6.15; p = 0.004), the use of assisted mechanical ventilation (AMV) (OR: 7.83; 95 % CI: 3.31-18.49; p = 0.0001) and central venous catheter (CVC) (OR: 38.08; 95 % CI: 5.16-280.95; p = 0.0001), and prolonged hospital stays (OR: 9.65; 95 % CI: 4.33-21.49; p = 0.0001).

CONCLUSIONS

The incidence of morbidity was 3.56 % and was associated with an age younger than 1 year, patient severity at the time of admission, the use of AMV and CVC, and prolonged hospital stays.

摘要

介绍

功能状态量表(FSS)是为测量儿科患者获得性发病而开发的。

目的

估计儿科重症监护病房(PICU)获得性发病的发生率和相关因素的存在,并描述出院后的功能状态。

人群和方法

前瞻性队列。所有 2016 年 8 月至 2017 年 7 月期间入住 PICU 的患者。在住院期间和出院后 1 年内使用 FSS 来测量获得性发病。进行单变量分析以调查发病相关因素。

结果

共纳入 842 例患者。PICU 的发病发生率为 3.56%(30/842),整个队列在出院时仍为 0.7%(6/842)。出院后 1 年内,6 例患者中有 3 例功能状态改善。单变量分析显示,PICU 获得性发病与 PIM2 评分(优势比 [OR]:1.04;95%置信区间 [CI]:1.01-1.07;p = 0.007)、年龄小于 1 岁(OR:2.93;95%CI:1.36-6.15;p = 0.004)、使用辅助机械通气(AMV)(OR:7.83;95%CI:3.31-18.49;p = 0.0001)和中心静脉导管(CVC)(OR:38.08;95%CI:5.16-280.95;p = 0.0001)和住院时间延长(OR:9.65;95%CI:4.33-21.49;p = 0.0001)相关。

结论

发病发生率为 3.56%,与 1 岁以下年龄、入院时患者严重程度、使用 AMV 和 CVC 以及住院时间延长相关。

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