5471例儿科留观病例分析暨儿科急诊观察室功能评价
Evaluation of a pediatric emergency observation unit:an analysis of 5471 observation pediatric patients
目的 评估儿科急诊观察室的功能.方法 回顾性分析2006年1月至12月温州医学院附属第二医院儿科急诊观察室的病历记录和儿内科住院患者的出院诊断.用率的95%置信区间表示疾病在观察室的使用及从观察室转病区的需要.用优势比(odds ratios,OR)及95%置信区间表示某些疾病对观察室利用的优势.结果 观察室床位45张,收住患者5471人次,病区床位348张,收住患者12 881人次,观察室收住患者数足病区的42.5%,平均每床1年收住患者122人,是病区的3倍.观察室出院3879人次(70.9%),转病区住院1592人次(29.1%).观察室患者年龄中位数7岁,≤2岁占65.6%.住院时间中佗数95.7 h.呼吸和消化系统疾患是留住观察窜患者最常见的疾病,分别占患者总数的40.3%和17.5%.观察室利用率高的疾病分别为:喉炎73/75(97.3%);中毒277/285(97.2%);哮喘128/133(%.2%);高热惊厥251/271(92.6%);肠炎伴脱水618/726(85.1%);无热惊厥274/365(75.I%);上呼吸道感染486/624(77.9%).上述疾病对观察窒利用的优势与对病区利用的优势比较:中毒OR 43.2(26.1,71.6),P<0.01;喉炎OR 15.7(8.3,29.7),P<0.01;哮喘OR 10.5(7.0,15.8),P<0.01;高热惊厥OR 8.5(6.5,11.1),P<0.01;无热惊厥OR 2.6(2.2,3.i),P<0.001;上呼吸道感染OR 1.0(0.9,1.1),P=0.591,肠炎伴脱水OR 1.0(0.9,1.1),P=0.919,两者对观察室和病区的利用优势无明显区别.结论 儿科急诊观察室在儿科、尤其婴幼儿患者常见疾病的观察、治疗和住院周转等方面具有容量大、周转快、每床利用率高的特点,并为儿科某些特定疾病的治疗提供了一个新的选择空间.在门急诊容量很大的儿童医院扩建观察室是对医院资源更有效的利用.
更多Objective To evaluatethefunctions of an emergency pediatric observation unit(OU).Method The OU located in the Second Affdiated Hospital &Yuying Children'Hospital of Wenzhou Medical CoHege.a pediatric tertiary care teaching hospital.The records of all patients admitted to OU and the discharge diagnoses of all patients ofinpatient unit(IU)from January to December 2006 were retrospectively analyzed.[)d(Is ratios(OR) witll 95%C1 was used to show the advantages ofOU in SOme pedian4c diSOrders.Results There were45 beds in the OU,and 348 beds in tlle IU.111e number ofthe patients in OU per year WaS 42.5%compared to IU f5471 Vs.12 881).The average number of patients in OU per bed in one year WaS 122.which was 3 times as much as the average number of patients in IU admission per bed(122 vs.37).Totally 3879(70.9%)patients in OU were discharged and 1592(29.1%)were transferred.For the olmervation patie.ts,the IIIeaIl age Was 7 years old.with 65.6%under or equal to 2 years old.The 111ean le,ch of stay(IDS)in OU was95.7 hours.Respiratory disorders(2204/5471,40.3%)and gastrointestinal problems(960/5471,17.5%)were the most common disease in OU.Of the total admission(IU and ou),diagnoses with high OU utilization were croup(73/75,97.3%),poiflonin(277/,97.2%),flsthma(128/133,96.2%),fleiZl.1lwith high fever(274/365,75.1%),enteritis/dehydration(618/726,85.1%),seizure with 110 fever(274/365,75.1%)and acute respiratory infection(486/624.77.9%).The likelihood of an OU admifor these illness vells IU addlission(adjusted for subsequent need for IU admission)was poisonings OR 43.21(26.1,71.6),P<0.001;croup 15.7(8.3,29.7),P<0.001:asthma 0R 10.5(7.0,15.8),P<0.001;seizure with high fever OR 8.5(6.5,11.1),P<0.001;seizure with no fever2.6(2.2,3.1),P<0.001;acute respiratory infection 0R 1.0(0.9,1.1),P=O.591;enteritis/dehydration 1.0(0.9 1.1),P=0.919.Conclusions The emergency OU,characterized by large ac.commodation,fast circulation and high utilization rate of bed,plays an important role in observation,treatment and hospital admission of children,esoeeially infants and young children for common pediatric diseases.The emergency observation unit is also an alternative disposition for certain pediatric diseases.The extending construefion of OU in a childrenS hospital with big population of out-/in-patients is an effective way to the hospital resources.
More- 浏览:336
- 被引:12
- 下载:140
相似文献
- 中文期刊
- 外文期刊
- 学位论文
- 会议论文