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东埃塞俄比亚儿科重症监护病房住院儿童低钠血症及其相关因素的横断面研究。

Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study.

机构信息

Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

BMC Pediatr. 2023 Jun 20;23(1):310. doi: 10.1186/s12887-023-04118-7.

Abstract

BACKGROUND

Hyponatremia is a serious problem that leads to substantial increases morbidity and mortality in critically ill children. The identification of risk factors, implementation of preventive measures, and timely diagnosis and management are crucial to reduce adverse events related to hyponatremia. Despite the higher burden of the problem in Ethiopia, evidence related to the risk factors for hyponatremia among children in Ethiopia is limited; in particular, no study has been identified in eastern Ethiopia. Therefore, we aimed to determine the magnitude of hyponatremia and its associated factors in children admitted to the pediatric intensive care unit at the Hiwot Fana Comprehensive Specialized University Hospital.

METHODS

A facility-based cross-sectional study was conducted using 422 medical records of pediatric patients admitted to the pediatric intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital from January 2019 to December 2022. Medical records were reviewed to collect data. Data were analyzed using a statistical package for social sciences (SPSS) version 26. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was set at p < 0.05.

RESULTS

The magnitude of hyponatremia was 39.1% (95% CL: 34.4-43.8%). The age of the child (aOR = 2.37;95% CL:1.31-4.31), diagnosis of sepsis (aOR = 2.33; 95% CL:1.41-3.84),   surgical procedures (aOR = 2.39; 95% CL:1.26-4.56), nutritional status (aOR = 2.60; 95% CL:1.51-4.49), and length of hospital stay (aOR = 3.04; 95% CL: 1.73-5.33) were factors significantly associated with hyponatremia.

CONCLUSIONS

Four out of ten children admitted to pediatric intensive care units had hyponatremia. Hyponatremia was significantly associated with the age of the child, malnutrition, sepsis, surgical procedures, and length of hospital stay. To reduce the burden of hyponatremia and associated mortality, attention should be focused on improving the care of malnourished children, and those with sepsis, and the quality of postoperative monitoring services. Moreover, intervention strategies aimed at reducing the burden of hyponatremia should target the identified factors.

摘要

背景

低钠血症是一种严重的问题,会导致危重症儿童的发病率和死亡率显著增加。识别风险因素、实施预防措施以及及时诊断和管理对于降低与低钠血症相关的不良事件至关重要。尽管在埃塞俄比亚,该问题的负担更高,但与埃塞俄比亚儿童低钠血症相关的风险因素的证据有限;特别是,在埃塞俄比亚东部没有发现相关研究。因此,我们旨在确定在 Hiwot Fana 综合专科医院儿科重症监护病房(PICU)住院的儿童中低钠血症的严重程度及其相关因素。

方法

这是一项基于机构的横断面研究,使用了 2019 年 1 月至 2022 年 12 月期间在 Hiwot Fana 综合专科医院儿科 PICU 住院的 422 名儿科患者的病历进行研究。病历被审查以收集数据。数据使用社会科学统计软件包(SPSS)版本 26 进行分析。使用二项逻辑回归模型,采用调整后的优势比(aOR)和 95%置信区间(CI)来确定与结局变量相关的因素。统计显著性设为 p < 0.05。

结果

低钠血症的发生率为 39.1%(95%CL:34.4-43.8%)。儿童年龄(aOR=2.37;95%CL:1.31-4.31)、脓毒症诊断(aOR=2.33;95%CL:1.41-3.84)、手术程序(aOR=2.39;95%CL:1.26-4.56)、营养状况(aOR=2.60;95%CL:1.51-4.49)和住院时间(aOR=3.04;95%CL:1.73-5.33)是与低钠血症显著相关的因素。

结论

十分之四的儿童在进入儿科重症监护病房时患有低钠血症。低钠血症与儿童年龄、营养不良、脓毒症、手术程序和住院时间显著相关。为了降低低钠血症和相关死亡率的负担,应重点关注改善营养不良儿童以及脓毒症儿童的护理,并提高术后监测服务的质量。此外,旨在降低低钠血症负担的干预策略应针对已确定的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61bf/10280886/7491b1bdf7e4/12887_2023_4118_Fig1_HTML.jpg

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