Why pediatric patients with cancer visit the emergency department: United States, 2006-2010.
Why pediatric patients with cancer visit the emergency department: United States, 2006-2010.
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DOI：
10.1002/pbc.25288
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发表时间：
2015-03
影响因子：
3.2
通讯作者：
Macy, Michelle L.
中科院分区：
文献类型：
--
作者：
Mueller, Emily L.;Sabbatini, Amber;Gebremariam, Achamyeleh;Mody, Rajen;Sung, Lillian;Macy, Michelle L.
关于急诊科（艾德）在儿科癌症患者中的使用知之甚少。我们探讨了促使急诊科（艾德）就诊的原因和与入院相关的因素。使用美国最大的艾德就诊全付费者数据库全国急诊科样本对2006-2010年儿科艾德就诊进行回顾性队列分析。使用临床分类软件识别儿童癌症患者（年龄≤19岁）。确定了前十位非癌症诊断的就诊比例和分布。采用加权多因素Logistic回归分析与入院和出院相关的因素。在研究期间，美国有294，289例艾德儿科癌症患者就诊。发热和发热伴中性粒细胞减少（FN）是两种最常见的诊断，占就诊的近20%。44%的儿童癌症患者被同一家医院收治，FN的入院率高达82%。入院的风险因素为：FN（比值比（OR）8.58; 95%置信区间（CI）5.97-12.34）;仅中性粒细胞减少症（OR 7.28; 95% CI 5.08-10.43），年龄0-4岁与15-19岁相比（OR 1.19; 95% CI 1.08-1.31）和最高家庭收入中位数邮政编码（OR 1.27; 95% CI 1.08-1.49）与最低相比。自费就诊者的入院率低于公费就诊者（OR 0.42; 95%CI 0.35-0.51）。FN是儿科癌症患者艾德就诊的最常见原因，也是与入院最密切相关的疾病。社会经济因素似乎影响这一人群的艾德处置。
Little is known about emergency department (ED) use among pediatric patients with cancer. We explored reasons prompting emergency department (ED) visits and factors associated with hospital admission. A retrospective cohort analysis of pediatric ED visits from 2006-2010 using the Nationwide Emergency Department Sample, the largest all-payer database of United States ED visits. Pediatric patients with cancer (ages ≤19 years) were identified using Clinical Classification Software. Proportion of visits and disposition for the top ten-ranking non-cancer diagnoses were determined. Weighted multivariate logistic regression was performed to analyze factors associated with admission versus discharge. There were 294,289 ED visits by pediatric patients with cancer in the US over the study period. Fever and fever with neutropenia (FN) were the two most common diagnoses, accounting for almost 20% of visits. Forty-four percent of pediatric patients with cancer were admitted to the same hospital, with admission rates up to 82% for FN. Risk factors for admission were: FN (odds ratio (OR) 8.58; 95% confidence interval (CI) 5.97-12.34); neutropenia alone (OR 7.28; 95% CI 5.08-10.43), ages 0-4 years compared with 15-19 years (OR 1.19; 95% CI 1.08-1.31) and highest median household income ZIP code (OR 1.27; 95% CI 1.08-1.49) compared with lowest. “Self-pay” visits had lower odds of admission (OR 0.42; 95% CI 0.35-0.51) compared with public payer. FN was the most common reason for ED visits among pediatric patients with cancer and is the condition most strongly associated with admission. Socioeconomic factors appear to influence ED disposition for this population.
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影响因子：
45.3
作者：
Sung, L;Feldman, BM;Llewellyn-Thomas, HA
通讯作者：
Llewellyn-Thomas, HA
影响因子：
39.2
作者：
BODEY, GP;BUCKLEY, M;FREIREICH, EJ
通讯作者：
FREIREICH, EJ
影响因子：
45.3
作者：
Lehrnbecher, Thomas;Phillips, Robert;Sung, Lillian
通讯作者：
Sung, Lillian
影响因子：
8
作者：
Hasegawa, Kohei;Tsugawa, Yusuke;Camargo, Carlos A., Jr.
通讯作者：
Camargo, Carlos A., Jr.
影响因子：
8
作者：
Teuffel, Oliver;Amir, Eitan;Sung, Lillian
通讯作者：
Sung, Lillian