Incidence of Hospital-Acquired Conditions During Pediatric Clinical Research Inpatient Hospitalizations: A Matched Cohort Study.
Incidence of Hospital-Acquired Conditions During Pediatric Clinical Research Inpatient Hospitalizations: A Matched Cohort Study.
复制标题
儿科临床研究住院期间医院获得性疾病的发生率：一项匹配队列研究。
DOI：
10.1097/pts.0000000000001159
复制
发表时间：
2023
影响因子：
2.2
通讯作者：
Ozonoff,Al
中科院分区：
文献类型：
--
作者：
Milliren,CarlyE;Denhoff,EricaR;Hahn,PhillipD;Ozonoff,Al
ObjectivesIn this matched cohort study using data from pediatric hospitals，we compared hospital-acquired conditions（HACs）during clinical research hospitalizations.MethodsUsing Pediatric Health Information System data for institution discharges January 2017-June 2022，we matched research hospitals根据年龄（±3岁）、性别、出院年份（±2年），和所有患者精确诊断相关组分类、疾病严重程度（±1）和死亡风险（±1）。我们计算了（每1000次出院）和发病率（每10，000患者日）的HAC确定的国际疾病分类，第十次修订，代码和比较研究与非研究使用逻辑和泊松回归，占匹配使用广义估计方程和调整社会人口因素和医院utilization.ResultsWe匹配7000研究住院26，28家医院的447名非研究人员。中位年龄为6.0岁（四分位距，10.6岁）。中位住院时间为4.0天（四分位距，11.0天），研究性住院的住院时间更长（P< 0.001）。研究性住院患者中HAC的发生率为13.1/1000，而非研究性住院患者为7.2/1000（P< 0.001），发病率为6.7/10000患者日，而非研究性住院患者为4.5/10000患者日。调整社会人口统计学和临床因素后，研究停留时间是任何HAC的1.65倍（95%可信区间，1.27-2.16; P< 0.001），发病率为1.38倍（95%可信区间，1.09-1.75; P= 0.009）。结论我们的研究结果表明，儿科研究性住院治疗更有可能经历HACs相比，非研究性住院治疗。这些发现对儿科住院临床研究具有重要的安全意义，值得进一步研究。
ObjectivesIn this matched cohort study using data from pediatric hospitals, we compared the incidence of hospital-acquired conditions (HACs) during clinical research hospitalizations to nonresearch hospitalizations.MethodsUsing Pediatric Health Information System data for inpatient discharges January 2017–June 2022, we matched research hospitalizations (identified by International Classification of Diseases, Tenth Revision, diagnosis code) to nonresearch hospitalizations within hospital on age (±3 y), sex, discharge year (±2), and All Patients Refined Diagnosis Related Groups classification, severity of illness (±1), and risk of mortality (±1). We calculated the incidence (per 1000 discharges) and incidence rate (per 10,000 patient days) of HAC identified by International Classification of Diseases, Tenth Revision, codes and compare research versus nonresearch using logistic and Poisson regression, accounting for matching using generalized estimating equations and adjusting for sociodemographic factors and hospital utilization.ResultsWe matched 7000 research hospitalizations to 26,447 nonresearch from 28 hospitals. Median age was 6.0 years (interquartile range, 10.6 y). Median length of stay was 4.0 days (interquartile range, 11.0 days) with longer stays among research hospitalizations (P< 0.001). Incidence of HAC among research hospitalizations was 13.1 versus 7.2 per 1000 for nonresearch (P< 0.001) and incidence rate 6.7 versus 4.5 per 10,000 patient days. Adjusting for sociodemographic and clinical factors, research stays had 1.65 times the odds of any HAC (95% confidence interval, 1.27–2.16; P< 0.001) and 1.38 times the incidence rate (95% confidence interval, 1.09–1.75; P= 0.009).ConclusionsOur findings indicate that pediatric research hospitalizations are more likely to experience HACs compared with nonresearch hospitalizations. These findings have important safety implications for pediatric inpatient clinical research that warrant further study.