A Retrospective Case-Control Study to Identify Predictors of Unplanned Admission to Pediatric Intensive Care Within 24 Hours of Hospitalization.
Pediatr Crit Care Med
; 20(7): e293-e300, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31149966
ABSTRACT
OBJECTIVES:
To identify the clinical findings available at the time of hospitalization from the emergency department that are associated with deterioration within 24 hours.DESIGN:
A retrospective case-control study.SETTING:
A pediatric hospital in Ottawa, ON, Canada. PATIENTS Children less than 18 years old who were hospitalized via the emergency department between January 1, 2008, and December 31, 2012. Cases (n = 98) had an unplanned admission to the PICU or unexpected death on the hospital ward within 24 hours of hospitalization and controls (n = 196) did not.INTERVENTIONS:
None. MAINRESULTS:
Ninety-eight children (53% boys; mean age 63.2 mo) required early unplanned admission to the PICU. Multivariable conditional logistic regression resulted in a model with five predictors reaching statisticalsignificance:
higher triage acuity score (odds ratio, 4.1; 95% CI, 1.7-10.2), tachypnea in the emergency department (odds ratio, 4.6; 95% CI, 1.8-11.8), tachycardia in the emergency department (odds ratio, 2.6; 95% CI, 1.1-6.5), PICU consultation in the emergency department (odds ratio, 8.0; 95% CI, 1.1-57.7), and admission to a ward not typical for age and/or diagnosis (odds ratio, 4.5; 95% CI, 1.7-11.6).CONCLUSIONS:
We have identified risk factors that should be included as potential predictor variables in future large, prospective studies to derive and validate a weighted scoring system to identify hospitalized children at high risk of early clinical deterioration.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Unidades de Terapia Intensiva Pediátrica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article