Д. В. Прометной, Ю. С. Александрович, Алексей Николаевич Шмаков
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Among the predictors of death in a hospital (90 out of 151 patients, 60%), we determined the disease duration up to 24 hours (odds ratio, OR, 2.1, 95% confidence interval, CI, 2.1–4.1), self-referral hospitalization (OR 3.0, 95% CI 1.1–10.4), hospitalization in a moderate (OR 19.6, 95% CI 12.6–337.4) or extremely critical condition (OR 103.1, 95% CI 6.2–1,718.9), sepsis/generalized infection (OR 5.8, 95% CI 2.3–15.0), decrease in diastolic blood pressure (BP) ≥ 20% of the reference value (OR 7.0, 95% CI 1.3–38.4), score ≤ 14 points by the Glasgow coma scale (OR 10.6, 95% CI 4.1–24.6). Predictors of death at the resuscitation phase (72 of 133 patients, 54%) included cerebral dysfunction (OR 3.8, 95% CI 1.5–9.1), shock (OR 3.1, 95% CI 1.3–7.0), decrease of ≥ 20% in the reference value for respiratory rate (OR 24.2, 95% CI 3.1–186.2), heart rate (OR 29.0, 95% CI 1.7–497.2), systolic blood pressure (OR 5.2, 95% CI 1.9–14.7), diastolic blood pressure (OR 5.4, 95% CI 1.9–15.3), increase of ≥ 20% in the reference value for glucose level (OR 2.1, 95% CI 1.1–4.5), and creatinine (OR 4.3, 95% CI 1.5–12.6). Conclusion. We identified the predictors of death in children hospitalized in emergency. They can be used to consistently assess the risk of death in a hospital.","PeriodicalId":10919,"journal":{"name":"Current Paediatrics","volume":"51 1","pages":"424-430"},"PeriodicalIF":0.0000,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"ПРЕДИКТОРЫ ЛЕТАЛЬНОГО ИСХОДА У ГОСПИТАЛИЗИРОВАННЫХ В ЭКСТРЕННОМ ПОРЯДКЕ ДЕТЕЙ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ\",\"authors\":\"Д. В. Прометной, Ю. С. Александрович, Алексей Николаевич Шмаков\",\"doi\":\"10.15690/VSP.V16I5.1807\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Incorporation of death risk factors in case of urgent pathology in children remains a matter of argument. Objective. Our aim was to determine death predictors in children hospitalized in emergency. Methods. In a retrospective cohort study, we analyzed the data of inpatient's medical records (form 003/u) of resuscitation patients aged 0–17 years hospitalized in the Rostov region in 2006–2017. We recorded a favourable outcome of the underlying disease in case of patient discharge from the hospital and death in case of death in the hospital. Results. We studied the data of 151 children (boys — 61%), median age 10 (2; 36) months. Among the predictors of death in a hospital (90 out of 151 patients, 60%), we determined the disease duration up to 24 hours (odds ratio, OR, 2.1, 95% confidence interval, CI, 2.1–4.1), self-referral hospitalization (OR 3.0, 95% CI 1.1–10.4), hospitalization in a moderate (OR 19.6, 95% CI 12.6–337.4) or extremely critical condition (OR 103.1, 95% CI 6.2–1,718.9), sepsis/generalized infection (OR 5.8, 95% CI 2.3–15.0), decrease in diastolic blood pressure (BP) ≥ 20% of the reference value (OR 7.0, 95% CI 1.3–38.4), score ≤ 14 points by the Glasgow coma scale (OR 10.6, 95% CI 4.1–24.6). Predictors of death at the resuscitation phase (72 of 133 patients, 54%) included cerebral dysfunction (OR 3.8, 95% CI 1.5–9.1), shock (OR 3.1, 95% CI 1.3–7.0), decrease of ≥ 20% in the reference value for respiratory rate (OR 24.2, 95% CI 3.1–186.2), heart rate (OR 29.0, 95% CI 1.7–497.2), systolic blood pressure (OR 5.2, 95% CI 1.9–14.7), diastolic blood pressure (OR 5.4, 95% CI 1.9–15.3), increase of ≥ 20% in the reference value for glucose level (OR 2.1, 95% CI 1.1–4.5), and creatinine (OR 4.3, 95% CI 1.5–12.6). Conclusion. We identified the predictors of death in children hospitalized in emergency. 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引用次数: 2
摘要
背景。在儿童紧急病理病例中纳入死亡危险因素仍然是一个有争议的问题。目标。我们的目的是确定急诊住院儿童的死亡预测因素。方法。在回顾性队列研究中，我们分析了2006-2017年罗斯托夫地区0-17岁住院复苏患者的住院病历(表格003/u)数据。我们记录了一个有利的结果，基础疾病的情况下，病人出院和死亡的情况下，在医院死亡。结果。我们研究了151名儿童的数据(男孩占61%)，中位年龄为10岁(2岁;36个月。在医院死亡的预测因子中(151例患者中有90例，60%)，我们确定了疾病持续时间长达24小时(优势比，OR, 2.1, 95%可信区间，CI, 2.1 - 4.1)、自我转诊住院(OR 3.0, 95% CI, 1.1-10.4)、中度住院(OR 19.6, 95% CI 12.6-337.4)或极度危重住院(OR 103.1, 95% CI 6.2 - 1718.9)、败血症/全身性感染(OR 5.8, 95% CI 2.3-15.0)、舒张压(BP)下降≥参考值的20% (OR 7.0, 95% CI 1.3-38.4)，格拉斯哥昏迷评分≤14分(OR 10.6, 95% CI 4.1-24.6)。在复苏阶段死亡的预测因子(包括72 133例,54%)脑功能障碍(或3.8,95%可信区间1.5 - -9.1),冲击(或3.1,95%可信区间1.3 - -7.0),降低呼吸速率的参考价值≥20%(或24.2,95% CI 3.1 - -186.2)、心率(或29.0,95% CI 1.7 - -497.2)、收缩压(或5.2,95% CI 1.9 - -14.7)、舒张压(或5.4,95%可信区间1.9 - -15.3),增加血糖水平的参考价值≥20%(或2.1,95%可信区间1.1 - -4.5),和肌酐(OR 4.3, 95% CI 1.5-12.6)。结论。我们确定了急诊住院儿童死亡的预测因素。它们可以用来持续评估医院的死亡风险。
ПРЕДИКТОРЫ ЛЕТАЛЬНОГО ИСХОДА У ГОСПИТАЛИЗИРОВАННЫХ В ЭКСТРЕННОМ ПОРЯДКЕ ДЕТЕЙ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО КОГОРТНОГО ИССЛЕДОВАНИЯ
Background. Incorporation of death risk factors in case of urgent pathology in children remains a matter of argument. Objective. Our aim was to determine death predictors in children hospitalized in emergency. Methods. In a retrospective cohort study, we analyzed the data of inpatient's medical records (form 003/u) of resuscitation patients aged 0–17 years hospitalized in the Rostov region in 2006–2017. We recorded a favourable outcome of the underlying disease in case of patient discharge from the hospital and death in case of death in the hospital. Results. We studied the data of 151 children (boys — 61%), median age 10 (2; 36) months. Among the predictors of death in a hospital (90 out of 151 patients, 60%), we determined the disease duration up to 24 hours (odds ratio, OR, 2.1, 95% confidence interval, CI, 2.1–4.1), self-referral hospitalization (OR 3.0, 95% CI 1.1–10.4), hospitalization in a moderate (OR 19.6, 95% CI 12.6–337.4) or extremely critical condition (OR 103.1, 95% CI 6.2–1,718.9), sepsis/generalized infection (OR 5.8, 95% CI 2.3–15.0), decrease in diastolic blood pressure (BP) ≥ 20% of the reference value (OR 7.0, 95% CI 1.3–38.4), score ≤ 14 points by the Glasgow coma scale (OR 10.6, 95% CI 4.1–24.6). Predictors of death at the resuscitation phase (72 of 133 patients, 54%) included cerebral dysfunction (OR 3.8, 95% CI 1.5–9.1), shock (OR 3.1, 95% CI 1.3–7.0), decrease of ≥ 20% in the reference value for respiratory rate (OR 24.2, 95% CI 3.1–186.2), heart rate (OR 29.0, 95% CI 1.7–497.2), systolic blood pressure (OR 5.2, 95% CI 1.9–14.7), diastolic blood pressure (OR 5.4, 95% CI 1.9–15.3), increase of ≥ 20% in the reference value for glucose level (OR 2.1, 95% CI 1.1–4.5), and creatinine (OR 4.3, 95% CI 1.5–12.6). Conclusion. We identified the predictors of death in children hospitalized in emergency. They can be used to consistently assess the risk of death in a hospital.
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