资源有限环境下入住重症监护病房的儿科患者预后相关因素：横断面研究
Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study.
作者信息
Dendir Getahun, Awoke Nefsu, Alemu Afework, Sintayhu Ashagrie, Eanga Shamill, Teshome Mistire, Zerfu Mahlet, Tila Mebratu, Dessu Blen Kassahun, Efa Amelework Gonfa, Gashaw Amanu
机构信息
School of Anesthesia, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
出版信息
Pediatric Health Med Ther. 2023 Mar 2;14:71-79. doi: 10.2147/PHMT.S389404. eCollection 2023.
BACKGROUND
Critical care is a multidisciplinary and interprofessional specialty devoted to treating patients who already have or are at danger of developing acute, life-threatening organ dysfunction. Due to the higher disease load and mortality from preventable illness, patient outcomes in intensive care units are challenging in settings with inadequate resources. This study aimed to determine factors associated with outcomes of pediatric patients admitted to intensive care units.
METHODS
A cross-sectional study was conducted at Wolaita Sodo and Hawassa University teaching hospitals in southern Ethiopia. Data were entered and analyzed using SPSS version 25. Normality tests using the Shapiro-Wilk and Kolmogorov-Smirnov data were normally distributed. The frequency, percentage, and cross-tabulation of the different variables were then determined. Finally, the magnitude and associated factors were first analyzed using binary logistic regression and then multivariate logistic regression. Statistical significance was set at P < 0.05.
RESULTS
A total of 396 Pediatric ICU patients were included in this study, and 165 (41.7%) deaths were recorded. The odds of patients from urban areas (AOR = 45%, CI 95%: 8%, 67% p-value = 0.025) were less likely to die than those in rural areas. Patients with co morbidities (AOR = 9.4, CI 95%: 4.5, 19.7, p = 0.000) were more likely to die than pediatric patients with no co-morbidities. Patients admitted with Acute respiratory distress syndrome (AOR = 12.86, CI 95%: 4.3, 39.2, p = 0.000) were more likely to die than those with not. Pediatric patients on mechanical ventilation (AOR = 3, CI 95%: 1.7, 5.9, p = 0.000) more likely to die than not mechanically ventilated.
CONCLUSION
Mortality of paediatric ICU patients was high (40.7%) in this study. Co-morbid disease, residency, the use of inotropes, and the length of ICU stay were all statistically significant predictors of death.
背景
重症监护是一个多学科和跨专业的专业领域，致力于治疗已经患有或有发展为急性、危及生命的器官功能障碍风险的患者。由于可预防疾病导致的疾病负担和死亡率较高，在资源不足的情况下，重症监护病房的患者治疗结果具有挑战性。本研究旨在确定与入住重症监护病房的儿科患者治疗结果相关的因素。
方法
在埃塞俄比亚南部的沃莱塔索多和哈瓦萨大学教学医院进行了一项横断面研究。使用SPSS 25版录入和分析数据。使用夏皮罗-威尔克检验和柯尔莫哥洛夫-斯米尔诺夫检验进行正态性检验，数据呈正态分布。然后确定不同变量的频率、百分比和交叉表。最后，首先使用二元逻辑回归分析效应大小和相关因素，然后进行多元逻辑回归分析。设定统计学显著性为P < 0.05。
结果
本研究共纳入396名儿科重症监护病房患者，记录到165例（41.7%）死亡。城市地区的患者死亡几率（调整后比值比[AOR]=45%，95%置信区间[CI]：8%，67%，P值=0.025）低于农村地区的患者。患有合并症的患者（AOR = 9.4，95%CI：4.5，19.7，P = 0.000）比无合并症的儿科患者死亡几率更高。因急性呼吸窘迫综合征入院的患者（AOR = 12.86，95%CI：4.3，39.2，P = 0.000）比未患该疾病的患者死亡几率更高。接受机械通气的儿科患者（AOR = 3，95%CI：1.7，5.9，P = 0.000）比未接受机械通气的患者死亡几率更高。
结论
本研究中儿科重症监护病房患者的死亡率较高（40.7%）。合并症、居住地、使用血管活性药物以及在重症监护病房的住院时间都是死亡的统计学显著预测因素。
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