资源匮乏国家埃塞俄比亚重症监护病房的儿科死亡率及其决定因素：一项系统评价和荟萃分析

The magnitude of pediatric mortality and determinant factors in intensive care units in a low-resource country, Ethiopia: a systematic review and meta-analysis.

作者信息

Molla Misganew Terefe, Endeshaw Amanuel Sisay, Kumie Fantahun Tarekegn, Lakew Tigist Jegnaw

机构信息

Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Department of Statistics, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia.

出版信息

Front Med (Lausanne). 2023 Apr 17;10:1117497. doi: 10.3389/fmed.2023.1117497. eCollection 2023.

DOI:10.3389/fmed.2023.1117497

PMID:37138739

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10149984/

Abstract

BACKGROUND

Pediatric mortality after being admitted to a pediatric intensive care unit in Ethiopia is high when compared to high-income countries. There are limited studies regarding pediatric mortality in Ethiopia. This systematic review and meta-analysis aimed to assess the magnitude and predictors of pediatric mortality after being admitted to an intensive care unit in Ethiopia.

METHODS

This review was conducted in Ethiopia after retrieving peer-reviewed articles and evaluating their quality using AMSTAR 2 criteria. An electronic database was used as a source of information, including PubMed, Google Scholar, and Africa Journal of Online Databases, using AND/OR Boolean operators. Random effects of the meta-analysis were used to show the pooled mortality of pediatric patients and its predictors. A funnel plot was used to assess the publication bias, and heterogeneity was also checked. The final result were expressed as an overall pooled percentage and odds ratio with a 95% confidence interval (CI) of < 0.05%.

RESULTS

In our review, eight studies were used for the final analysis with a total population of 2,345. The overall pooled mortality of pediatric patients after being admitted to the pediatric intensive care unit was 28.5% (95% CI: 19.06, 37.98). The pooled mortality determinant factors were included the use of a mechanical ventilator with an odds ratio (OR) of 2.64 (95% CI: 1.99, 3.30); the level of Glasgow Coma Scale <8 with an OR of 2.29 (95% CI: 1.38, 3.19); the presence of comorbidity with an OR of 2.18 (95% CI: 1.41, 2.95); and the use of inotropes with an OR of 2.36 (95% CI: 1.65, 3.06).

CONCLUSION

In our review, the overall pooled mortality of pediatric patients after being admitted to the intensive care unit was high. Particular caution should be taken in patients on the use of mechanical ventilators, the level of Glasgow Coma Scale of <8, the presence of comorbidity, and the use of inotropes.

SYSTEMATIC REVIEW REGISTRATION

https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/, identifier: 1460.

摘要

背景

与高收入国家相比，埃塞俄比亚儿科重症监护病房收治的患儿死亡率较高。埃塞俄比亚关于儿科死亡率的研究有限。本系统评价和荟萃分析旨在评估埃塞俄比亚重症监护病房收治患儿的死亡率及其预测因素。

方法

本评价在埃塞俄比亚进行，检索同行评审文章并使用AMSTAR 2标准评估其质量。使用电子数据库作为信息来源，包括PubMed、谷歌学术和非洲在线数据库期刊，使用AND/OR布尔运算符。荟萃分析的随机效应用于显示儿科患者的合并死亡率及其预测因素。使用漏斗图评估发表偏倚，并检查异质性。最终结果以总体合并百分比和比值比表示，95%置信区间（CI）<0.05%。

结果

在我们的评价中，八项研究用于最终分析，总样本量为2345例。儿科重症监护病房收治的儿科患者总体合并死亡率为28.5%（95%CI：19.06，37.98）。合并死亡率的决定因素包括使用机械通气，比值比（OR）为2.64（95%CI：1.99，3.30）；格拉斯哥昏迷量表评分<8，OR为2.29（95%CI：1.38，3.19）；存在合并症，OR为2.18（95%CI：1.41，2.95）；以及使用血管活性药物，OR为2.36（95%CI：1.65，3.06）。