泰国儿科重症监护病房中 15 至 18 岁青少年的特征、疗效和床位使用情况

Q3 Medicine Siriraj Medical Journal Pub Date : 2023-08-01 DOI:10.33192/smj.v75i8.263097
Suvikrom Law, Thakoon Butpech, Suwannee Phumeetham, Nutnicha Preeprem, Kawewan Limprayoon
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引用次数: 0

摘要

目的:儿科年龄段有扩大的趋势。在低收入和中等收入国家,需要接受重症监护的患者在 15-18 岁这个边界年龄段的特征尚不清楚。我院最近将儿科护理的截止年龄从 15 岁改为 18 岁。本研究的目的是确定这一变化后入住儿科重症监护病房(PICU)的 15-18 岁患者的特征、预后和床位使用情况。材料和方法:这是在一家三级医疗机构儿科重症监护病房进行的观察性研究。2019-2020年入住PICU的15-18岁患者均符合条件。研究人员查阅了病历。研究结果各年龄组共收治了 1030 名 PICU 患者。其中52名患者年龄在15-18岁之间,共收治68人。87%的患者患有慢性疾病。最常见的急性病是脓毒性休克和感染,最常见的慢性病是系统性红斑狼疮(SLE)和血液系统恶性肿瘤。47%的患者需要机械通气,36%的患者需要血管活性药物,27%的患者需要持续的肾脏替代治疗。15-18 岁患者的 PICU 死亡率明显高于年轻患者(13.24% 对 3.64%,P = 0.002)。住院死亡率为 22%。结论需要入住 PICU 的 15-18 岁患者慢性病患病率高,死亡率也高。应特别关注这一群体的护理。最常见的急性病是脓毒性休克和感染。最常见的慢性疾病是系统性红斑狼疮和血液系统恶性肿瘤。
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Characteristics, Outcomes and Bed Utilization of 15-to-18-Year-Old Adolescents in a Pediatric Intensive Care Unit in Thailand
Objective: There is a trend toward expanding pediatric age range. At the borderline age of 15-18 years, the characteristics of patients requiring intensive care admission in low- and middle-income countries are unknown. Our institution recently changed the cut-off age for pediatric care from 15 to 18 years. The objective of this study was to determine the characteristics, outcomes and bed utilization of patients aged 15-18 years admitted to pediatric intensive care unit (PICU) after this change. Materials and Methods: This is an observational study at a tertiary medical PICU. Patients aged 15-18 years admitted to PICU in 2019-2020 were eligible. Medical records were reviewed. Results: There were 1030 PICU admissions from all age groups. Fifty-two patients aged 15-18 years were admitted, with a total of 68 admissions. Eighty-seven percent had chronic conditions. The most common acute conditions were septic shock and infection, the most common chronic conditions were systemic lupus erythematosus (SLE) and hematologic malignancies. Forty-seven percent required mechanical ventilation, 36% required vasoactive medications and 27% required continuous renal replacement therapy. PICU mortality rate in patients aged 15-18 years old was significantly higher than that in the younger age group (13.24% vs 3.64%, p = 0.002). Hospital mortality rate was 22%. Conclusion: Patients aged 15-18 years requiring PICU admission had high prevalence of chronic conditions and high mortality risk. Special attention should be given to the care of this group. The most common acute conditions were septic shock and infection. The most common chronic conditions were SLE and hematologic malignancies.
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Siriraj Medical Journal
Siriraj Medical Journal Medicine-Medicine (all)
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审稿时长
8 weeks
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