Antonino Luna, Goossens Eva, van Olmen Josefien, Bael An, Hellinckx Johan, Van Ussel Isabelle, Wouters An, Jonckheer Tijl, Martens Tine, Van Nuijs Sascha, Van Rossem Carolin, Driesen Yentl, Jouret Nathalie, Ter Haar Eva, Rozenberg Sabine, Vanderschaeghe Els, van Steijn Susanne, Verhulst Stijn, Van Hoorenbeeck Kim
Laboratory of Experimental Medicine and Pediatrics, Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
Centre for Research and Innovation in Care, Department of Nursing Science and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
Children (Basel). 2024 Jan 26;11(2):164. doi: 10.3390/children11020164.
Asthma is the most prevalent chronic respiratory condition in children. An asthma exacerbation (AE) is a frequent reason for emergency department (ED) visits. An important step in the management of a moderate to severe AE is the administration of systemic corticosteroids (SCS) within 1 h after ED presentation. This study aimed to determine the timing of SCS administration and correlate this with the length of stay and oxygen therapy duration and to explore factors predicting timely administration.
This study used a retrospective multicenter observational design based on electronic medical records review. Children aged < 18 years, presenting to the ED with a moderate to severe AE were included.
205 patients were included. Only 28 patients received SCS within 60 min after ED arrival. The median time to SCS administration was 169 min (Q 92-Q 380). A correlation was found between timing and oxygen treatment duration (r = 0.363, < 0.001) and length of stay (r = 0.368, < 0.001). No patient characteristics predicted timely SCS administration.
Three in four children who presented with a moderate to severe AE at the ED did not receive SCS within the first hour. A prolonged timing of SCS administration correlated with a prolonged length of stay and extended need for oxygen support.
哮喘是儿童中最常见的慢性呼吸道疾病。哮喘急性加重（AE）是急诊就诊的常见原因。中重度AE治疗的重要一步是在急诊就诊后1小时内给予全身糖皮质激素（SCS）。本研究旨在确定SCS给药时间，并将其与住院时间和氧疗持续时间相关联，同时探索预测及时给药的因素。
本研究采用基于电子病历回顾的回顾性多中心观察性设计。纳入年龄＜18岁、因中重度AE到急诊就诊的儿童。
共纳入205例患者。只有28例患者在到达急诊后60分钟内接受了SCS治疗。SCS给药的中位时间为169分钟（四分位数间距92 - 380分钟）。发现给药时间与氧疗持续时间（r = 0.363，P＜0.001）和住院时间（r = 0.368，P＜0.001）之间存在相关性。没有患者特征能够预测SCS的及时给药。
四分之三在急诊因中重度AE就诊的儿童在首小时内未接受SCS治疗。SCS给药时间延长与住院时间延长和对氧支持需求增加相关。
