2023年埃塞俄比亚迪拉大学转诊医院24小时内入住儿科急诊室儿童的入院结局及其相关因素：一项横断面研究

Admission outcomes and their associated factors among children admitted to the paediatric emergency unit within 24 hours of Dilla University Referral Hospital, Ethiopia, 2023: a cross-sectional study.

作者信息

Dube Samuel Jigso, Seboka Binyam Tariku, Demeke Abel Desalegn, Feleke Mekdes Mekonnen, Jarso Abdo Hajo, Bati Asresu Feleke, Udo Etaferaw, Markos Selam Tadele, Kassaw Chalachew, Yeheyis Tomas, Debebe Amdehiwot Aynalem, Gechere Ephrem Geja, Dessie Yihenew Ayehu

机构信息

Department of Nursing, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia

School of Public Health, Dilla University, Dilla, Ethiopia.

出版信息

BMJ Open. 2025 Jan 20;15(1):e091359. doi: 10.1136/bmjopen-2024-091359.

DOI:10.1136/bmjopen-2024-091359

PMID:39832980

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11749754/

Abstract

BACKGROUND

Children in paediatric emergency units are those who need special attention, and unless treated early, they are a vulnerable population to unwanted outcomes like death, discharge against medical advice or referral to other institutions within 24 hours.

OBJECTIVES

To assess admission outcomes and their associated factors among children admitted to the paediatric emergency unit of Dilla University Referral Hospital, Ethiopia, 2023.

METHODS

An institution-based cross-sectional study design was employed among children admitted to the paediatric emergency unit at Dilla University Referral Hospital from 8 May 2023 to 8 June 2023. A total of 885 complete charts of the children aged 29 days to 14 years were analysed. Structured checklist was used for data collection. STATA V.14 was used for data analysis. A multinomial logistic regression model was used to determine the factors associated with admission outcomes. Overall model fitness was checked using the likelihood ratio test.

RESULT

Out of 885 patient charts reviewed, the magnitude of patients improved, transferred, died, referred and discharged against medical advice was 51%, 40.9%, 7.6%, 0.1% and 0.4%, respectively. Children presented with diarrhoea (adjusted OR (AOR) =2.92, 95% CI 1.46 to 5.84), severe respiratory distress (AOR=5.08, 95% CI 2.49 to 10.35), coma (AOR=3.71, 95% CI 1.24 to 11.13), comorbidity (AOR=3.33, 95% CI 1.49 to 7.41) and delay to seek healthcare (AOR=1.99, 95% CI 1.03 to 3.83) were significantly associated factors with emergency unit mortality, whereas pneumonia (AOR=1.76, 95% CI 1.16 to 2.65) and severe acute malnutrition (AOR=3.46, 95% CI 2.06 to 5.81) were significantly associated factors with intrahospital unit/ward transfer.

CONCLUSION

The magnitude of mortality, transfer to the ward and discharge against medical advice were relatively higher. Interventions focused on early diagnoses, and the initiation of appropriate treatments was of the utmost relevance to improving patient outcomes.

摘要

背景

儿科急诊室的儿童是需要特别关注的群体，除非早期得到治疗，否则他们是一个易出现不良后果的脆弱群体，如死亡、违反医嘱出院或在24小时内转至其他机构。

目的

评估2023年埃塞俄比亚迪拉大学转诊医院儿科急诊室收治儿童的入院结局及其相关因素。

方法

采用基于机构的横断面研究设计，对2023年5月8日至2023年6月8日在迪拉大学转诊医院儿科急诊室收治的儿童进行研究。共分析了885份年龄在29天至14岁儿童的完整病历。使用结构化检查表进行数据收集。使用STATA V.14进行数据分析。采用多项逻辑回归模型确定与入院结局相关的因素。使用似然比检验检查总体模型拟合度。

结果

在审查的885份患者病历中，病情改善、转院、死亡、转诊和违反医嘱出院的患者比例分别为51%、40.9%、7.6%、0.1%和0.4%。出现腹泻（调整后比值比（AOR）=2.92，95%置信区间1.46至5.84）、严重呼吸窘迫（AOR=5.08，95%置信区间2.49至10.35）、昏迷（AOR=3.71，95%置信区间1.24至11.13）、合并症（AOR=3.33，95%置信区间1.49至7.41）和延迟就医（AOR=1.99，95%置信区间1.03至3.83）是与急诊室死亡率显著相关的因素，而肺炎（AOR=1.76，95%置信区间1.16至2.65）和重度急性营养不良（AOR=3.46，95%置信区间2.06至5.81）是与院内科室/病房转院显著相关的因素。