在埃及使用临床护理途径成功管理低风险发热性中性粒细胞减少症儿科患者。

IF 2.8 Q2 INFECTIOUS DISEASES
Reham Abdelaziz Khedr, Ebtehal Ali, Hadir Ahmed El-Mahallawy, Nashwa Ezz Eldeen
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引用次数: 0

摘要

背景:低风险发热性中性粒细胞减少症的家庭管理标准在支持性护理中仍然具有挑战性。谨慎选择低风险发热性中性粒细胞减少症患儿可以改善预后并减少并发症。在目前的研究中,我们采用严格的纳入标准,为到急诊室就诊的低风险发热性中性粒细胞减少症儿科患者实施了临床途径。材料和方法:这是一项前瞻性研究,时间为2021年12月至2022年9月;所有到急诊室就诊的患者都进行了路径评估筛查,并使用严格的检查表进行了风险分层。符合低风险标准的患者被纳入研究。对这些患者进行了彻底的临床和实验室评估。所有患者都开始口服抗生素,并被告知有警示迹象。患者于第3天和第7天在门诊随访。结果:共纳入200例低危发热性中性粒细胞减少症患者203例;男一百一十人,女九十人。潜在的血液系统恶性肿瘤占54.0%。第3天,200例患者中有181例(90.0%)发热24小时,47.5%仍有中性粒细胞减少。在第7天,所有的研究患者都发热,计数恢复,并且不管计数如何都停止使用抗生素。95.5%的患者在第7天绝对中性粒细胞计数恢复。结论:我们的低危发热性中性粒细胞减少患者纳入标准被证明是安全的,没有死亡或进入重症监护病房,并且入院率最低,因此可以用于管理计划,以避免不必要的患者入院,并帮助医疗保健提供者优化患者分配和安全随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful Management of Pediatric Patients with Low-Risk Febrile Neutropenia Using a Clinical Care Pathway in Egypt.

Background: Criteria for home management of low-risk febrile neutropenia remain challenging in supportive care. Careful selection of low-risk febrile neutropenic pediatric patients can improve outcomes and decrease complications. In the current study, we implemented a clinical pathway for pediatric patients presenting to the emergency room department with low-risk febrile neutropenia by using strict inclusion criteria.

Materials and methods: This is a prospective study from December 2021 to September 2022; all patients presented to the emergency room department were screened for pathway evaluation, and risk stratification was performed using a strict checklist. Patients were included if they met the low-risk criteria. Thorough clinical and laboratory assessments were performed on these patients. All patients started oral antibiotics and were instructed about alarming signs. Patients were followed up at the outpatient clinic on days 3 and 7.

Results: Two hundred and three patients with 200 episodes of low-risk febrile neutropenia were enrolled; one hundred and ten were males, and 90 were females; underlying hematological malignancies accounted for 54.0%. On day three, 181 patients out of 200 were afebrile for 24 hours (90.0%), and 47.5% were still neutropenic. At day seven, all study patients were afebrile, had recovering counts, and stopped antibiotics regardless of the count. Absolute neutrophil count recovery on day seven was achieved in 95.5% of patients.

Conclusion: Our inclusion criteria for patients with low-risk febrile neutropenia proved to be safe without deaths or intensive care unit admission and successful with the lowest admission rate, so it can be used for a stewardship program to avoid unnecessary patient admissions and help healthcare givers to optimize patient allocation and follow-up safely.

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来源期刊
Infection and Chemotherapy
Infection and Chemotherapy INFECTIOUS DISEASES-
CiteScore
6.60
自引率
11.90%
发文量
71
审稿时长
22 weeks
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