城市儿童医院中脊柱裂儿童和青少年意外住院的风险因素：一项横断面研究。

Risk factors for unanticipated hospitalizations in children and youth with spina bifida at an urban children's hospital: A cross-sectional study.

机构信息

Children's Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.

出版信息

Disabil Health J. 2023 Jan;16(1):101373. doi: 10.1016/j.dhjo.2022.101373. Epub 2022 Sep 5.

DOI:10.1016/j.dhjo.2022.101373

PMID:36156271

Abstract

BACKGROUND

Spina bifida (SB) is a condition resulting from the improper closure of the neural tube and vertebral column during fetal development. While patients' life expectancy and quality of life have improved dramatically due to medical advances, children continue to experience health-related issues that often require hospitalizations.

OBJECTIVE

The association among sociodemographic and clinical characteristics with potentially preventable hospitalizations (PPH) in children and youth with myelomeningocele type SB was investigated in this cross-sectional study.

METHODS

Chart reviews and data extraction were conducted on 108 children and youth, ages 1 month to 21 years, admitted for PPH in a regional children's academic medical center between May 2017 and July 2019. Sociodemographic variables included sex, age, type of insurance and ethnicity. Clinical variables included level of lesion, ambulation status, shunt dependency and selected diagnostic categories. Univariate, bivariate, and multivariate analyses were conducted to identify factors associated with PPH.

RESULTS

Factors associated with PPH included being male, ages 5-18 years, low lumbar level lesions, non-ambulatory, with public insurance, Hispanic and shunt dependent. Most hospitalizations (73%) were for neurologic or urologic conditions. Factors independently associated with PPH were ethnicity for urologic conditions, being ambulatory for metabolic conditions, and age for gastroenterology conditions.

CONCLUSION

Selected demographic and clinical variables were found to be associated with PPH of children and youth with myelomeningocele-type SB. The most common reasons for PPH were shunt malfunctions and urinary tract infections, consistent with other studies.

摘要

背景

脊柱裂（SB）是一种由于胎儿发育过程中神经管和脊柱闭合不当而导致的疾病。尽管由于医疗进步，患者的预期寿命和生活质量有了显著提高，但儿童仍会遇到健康相关问题，这些问题往往需要住院治疗。

目的

本横断面研究旨在探讨社会人口学和临床特征与脊髓脊膜膨出型 SB 患儿潜在可预防性住院（PPH）之间的关系。

方法

对 2017 年 5 月至 2019 年 7 月期间在一家地区性儿童学术医疗中心因 PPH 住院的 108 例 1 个月至 21 岁的儿童和青少年进行了病历回顾和数据提取。社会人口学变量包括性别、年龄、保险类型和种族。临床变量包括病变水平、活动能力、分流依赖和选定的诊断类别。进行了单变量、双变量和多变量分析，以确定与 PPH 相关的因素。