Association Between Corticosteroids and Outcomes in Children Hospitalized With Orbital Cellulitis.
Association Between Corticosteroids and Outcomes in Children Hospitalized With Orbital Cellulitis.
复制标题
皮质类固醇与因眼眶蜂窝织炎住院儿童的预后之间的关联。
DOI：
10.1542/hpeds.2021-005910
复制
发表时间：
2021
影响因子：
--
通讯作者：
J. Markham
中科院分区：
文献类型：
--
作者：
P. Gill;S. Mahant;M. Hall;P. Parkin;Samir S Shah;N. Wolter;M. Mestre;J. Markham
目标
研究全身性皮质类固醇的使用与美国儿童医院因眼眶蜂窝织炎住院的儿童的预后之间的关系。
方法
我们利用 2007 年至 2019 年儿科健康信息系统数据库的管理数据进行了一项多中心观察性研究。纳入了具有国际疾病分类第九版、临床修订版或第十修订版、临床修订版眼眶蜂窝组织炎出院诊断代码的 2 个月至 18 岁儿童。主要暴露是入院当天接受全身皮质类固醇。主要结局是住院时间，次要结局包括手术干预、入住 ICU、复诊和医疗费用。我们使用具有逆概率加权逻辑回归的广义逻辑模型来调整人口因素并评估报告的临床结果的差异。
结果
在 5832 名因眼眶蜂窝织炎住院的患者中，330 名（5.7%）属于皮质类固醇组，5502 名（94.3%）属于非皮质类固醇组。皮质类固醇组的患者年龄较大，病情更严重，并接受广谱抗生素治疗。在调整后的分析中，皮质类固醇暴露与住院时间、手术干预需求、ICU 入院、急诊科复诊、30 天再入院或住院费用的差异无关。将分析仅限于那些接受广谱抗生素的患者并没有改变研究结果。
结论
患有眼眶蜂窝织炎的住院儿童早期使用全身性皮质类固醇与改善临床结果无关。在临床试验之外，不应鼓励患有眼眶蜂窝织炎的住院儿童使用皮质类固醇。
OBJECTIVES
To examine the association between systemic corticosteroid use and outcomes for children hospitalized with orbital cellulitis at US children's hospitals.
METHODS
We conducted a multicenter observational study using administrative data from the Pediatric Health Information System database from 2007 to 2019. Children between the ages of 2 months and 18 years with International Classification of Diseases, Ninth Revision, Clinical Modification or 10th Revision, Clinical Modification discharge diagnostic codes of orbital cellulitis were included. The primary exposure was receipt of systemic corticosteroids on the day of hospital admission. The primary outcome was hospital length of stay, and secondary outcomes included surgical intervention, ICU admissions, revisits, and health care costs. We used generalized logit model with inverse probability weighting logistic regression to adjust for demographic factors and assess for differences in clinical outcomes reported.
RESULTS
Of the 5832 patients hospitalized with orbital cellulitis, 330 (5.7%) were in the corticosteroid group and 5502 (94.3%) were in the noncorticosteroid group. Patients in the corticosteroid group were older, had more severe illness, and received broad spectrum antibiotics. In adjusted analyses, corticosteroid exposure was not associated with differences in length of hospital stay, need for surgical intervention, ICU admissions, emergency department revisits, 30-day hospital readmissions, or hospital costs. Restricting the analysis to only those patients who received broad spectrum antibiotics did not change the findings.
CONCLUSIONS
Early use of systemic corticosteroids in hospitalized children with orbital cellulitis is not associated with improved clinical outcomes. Use of corticosteroids in hospitalized children with orbital cellulitis should be discouraged outside of clinical trials.
皮质类固醇治疗眶周和眼眶蜂窝织炎。
DOI：
10.1002/14651858.cd013535.pub2
发表时间：
2021
期刊：
The Cochrane database of systematic reviews
影响因子：
--
作者：
Kornelsen,Emily;Mahant,Sanjay;Parkin,Patricia;Ren,LilyYuxi;Reginald,YohannA;Shah,SamirS;Gill,PeterJ
通讯作者：
Gill,PeterJ