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与动脉导管未闭危重新生儿急性肾损伤相关的成本:儿科健康信息系统(PHIS)分析。

Costs associated with acute kidney injury in critically Ill neonates with patent Ductus arteriosus: pediatric health information system (PHIS) analysis.

机构信息

Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.

Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, USA.

出版信息

J Perinatol. 2022 Dec;42(12):1669-1673. doi: 10.1038/s41372-022-01499-y. Epub 2022 Sep 7.

DOI:10.1038/s41372-022-01499-y
PMID:36071104
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9722647/
Abstract

OBJECTIVE

Compare costs of hospitalization between critically-ill neonates with patent ductus arteriosus (PDA) who did and did not develop acute kidney injury (AKI).

STUDY DESIGN

Using the Children's Hospital Association's Pediatric Health Information System (PHIS) database, we ascertained the marginal estimated total cost of hospitalization between those who did and did not develop AKI.

RESULTS

Query of 49 PHIS centers yielded 14,217 neonates with PDA, 1697 with AKI and 12,520 without AKI. Predictors of cost included AKI, birth weight, ethnicity, race, length of stay (LOS), and Feudtner Complex Chronic Conditions Classification System. LOS was the strongest predictor (AKI: median 71 days [IQR 28-130]; No AKI: 28 days [10-76]; p < 0.01). Neonates with AKI had $48,416 greater costs (95% CI: $43,804-53,227) after adjusting for these predictors (AKI: $190,063, 95% CI $183,735-196,610; No AKI: $141,647, 95% CI $139,931-143,383 l; p < 0.01).

CONCLUSION

AKI is independently associated with increased hospital costs in critically-ill neonates with PDA.

摘要

目的

比较患有动脉导管未闭(PDA)且发生与未发生急性肾损伤(AKI)的危重新生儿的住院费用。

研究设计

使用儿童健康协会的儿科健康信息系统(PHIS)数据库,我们确定了发生与未发生 AKI 的患者之间住院总费用的边际估计值。

结果

对 49 个 PHIS 中心的查询得到了 14217 例患有 PDA 的新生儿、1697 例 AKI 患者和 12520 例无 AKI 患者。费用的预测因素包括 AKI、出生体重、民族、种族、住院时间(LOS)和 Feudtner 复杂慢性疾病分类系统。LOS 是最强的预测因素(AKI:中位数 71 天[IQR 28-130];无 AKI:28 天[10-76];p<0.01)。调整这些预测因素后,AKI 患者的费用增加了 48416 美元(95%CI:43804-53227)(AKI:190063 美元,95%CI:183735-196610 美元;无 AKI:141647 美元,95%CI:139931-143383 美元;p<0.01)。

结论

AKI 与患有 PDA 的危重新生儿的住院费用增加独立相关。

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Improving the identification of acute kidney injury in the neonatal ICU: three centers' experiences.改善新生儿重症监护病房中急性肾损伤的识别:三个中心的经验。
J Perinatol. 2022 Feb;42(2):243-246. doi: 10.1038/s41372-021-01198-0. Epub 2021 Sep 3.
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Relationship of patent ductus arteriosus management with neonatal AKI.动脉导管未闭治疗与新生儿急性肾损伤的关系。
J Perinatol. 2021 Jun;41(6):1441-1447. doi: 10.1038/s41372-021-01054-1. Epub 2021 Apr 19.
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The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study.新生儿重症监护病房中急性肾损伤意识的提高对急性肾损伤发生率和报告的影响:一项回顾性队列研究的结果。
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Acute kidney injury in paediatric patients with sickle cell disease is associated with increased morbidity and resource utilization.小儿镰状细胞病患者的急性肾损伤与发病率和资源利用增加有关。
Br J Haematol. 2020 May;189(3):559-565. doi: 10.1111/bjh.16384. Epub 2020 Feb 6.
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Acute Kidney Injury Guidelines Are Associated With Improved Recognition and Follow-up for Neonatal Patients.急性肾损伤指南与新生儿患者的识别和随访改善相关。
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Patent ductus arteriosus is associated with acute kidney injury in the preterm infant.动脉导管未闭与早产儿急性肾损伤有关。
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Birth weight, Apgar scores and gentamicin were associated with acute kidney injuries in VLBW neonates requiring treatment for patent ductus arteriosus.出生体重、阿普加评分和庆大霉素与需要治疗动脉导管未闭的极低出生体重儿的急性肾损伤有关。
Acta Paediatr. 2019 Apr;108(4):645-653. doi: 10.1111/apa.14563. Epub 2018 Oct 1.
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Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study.新生儿急性肾损伤的发病率及转归(AWAKEN):一项多中心、跨国观察性队列研究
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