Adverse Events Following Diagnostic Urethral Catheterization in the Pediatric Emergency Department
Adverse Events Following Diagnostic Urethral Catheterization in the Pediatric Emergency Department
复制标题
DOI：
10.1017/cem.2016.5
复制
发表时间：
2016-11-01
影响因子：
2.4
通讯作者：
Gravel, Jocelyn
中科院分区：
文献类型：
--
作者：
Ouellet-Pelletier, Julie;Guimont, Chantal;Gravel, Jocelyn
目的：本研究的目的是评估儿童诊断性导尿(UC)相关的不良事件，并确定其对患者及其家庭的影响。方法：这是一项在三级儿科医院急诊科进行的前瞻性队列研究。所有3到24个月大的发烧儿童，如果诊断为UC，都符合条件。同意参与的父母在UC后7至10天内被电话联系，回答一份询问并发症的标准化问卷。主要结果是UC后7天内发生不利事件，定义为排尿疼痛、生殖器疼痛、尿潴留、血尿或继发性尿路感染。结果：在完成研究的199例患者中，41例(21%)报告了并发症：19例(10%)儿童排尿疼痛，16例(8%)生殖器疼痛，11例(6%)尿潴留，9例(5%)肉眼血尿，1例(0.5%)继发性尿路感染。3名家长(1%)报告需要进一步的医疗护理，3名家长(1%)缺勤。两个独立变量(男性和年龄12-23个月)与较高的不良事件风险相关。结论：在术后一周内，21%的幼儿导尿与不良事件有关。因此，考虑到它可能导致不利事件，应该明智地在儿童中使用这一程序。
Objectives: The purpose of this study was to assess adverse events associated with diagnostic urethral catheterization (UC) in young children and to determine their impact on the patient and their family.Methods: This was a prospective cohort study conducted in the emergency department of a tertiary-care pediatric hospital. All 3-to 24-month-old children with fever who had a diagnostic UC were eligible. Parents who consented to participate were contacted by phone within 7 to 10 days after the UC to answer a standardized questionnaire inquiring about complications. The primary outcome was the occurrence of an unfavourable event in the seven days following UC, defined as painful urination, genital pain, urinary retention, hematuria or secondary urinary tract infection. Secondary outcomes included the need for further medical care and the need for parents to miss school or work.Results: Of the 199 patients who completed the study, 41 (21%) reported a complication: painful urination in 19 (10%) children, genital pain in 16 (8%), urinary retention in 11 (6%), gross hematuria in 9 (5%), and secondary urinary tract infection in 1 (0.5%). Three (1%) parents reported the need for further medical care and three (1%) missed work. Two independent variables (male sex and age 12-23 months) were associated with a higher risk of adverse events.Conclusions: Urethral catheterization is associated with adverse events in 21% of young children in the week following the procedure. Accordingly, this procedure should be used judiciously in children, considering its potential to cause unfavourable events.