Predicting respiratory hospital admissions in young people with cerebral palsy
Predicting respiratory hospital admissions in young people with cerebral palsy
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DOI：
10.1136/archdischild-2017-314346
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发表时间：
2018-12-01
影响因子：
5.2
通讯作者：
Wilson, Andrew C.
中科院分区：
文献类型：
--
作者：
Blackmore, Amanda Marie;Bear, Natasha;Wilson, Andrew C.
目的 确定脑瘫 (CP) 年轻人呼吸系统入院的早期预测因素。使用关联数据设计一项为期 3 年的前瞻性队列研究。患者为 CP 患者，年龄 1 至 26 岁。主要结果指标 在以下 3 年期间，自我报告和护理者报告的呼吸系统症状与呼吸系统入院相关（根据《国际疾病和相关健康问题统计分类》第 10 版修订代码定义）年。结果 招募了 482 名参与者（其中 289 名男性）。研究开始时，他们的年龄为 1 至 26 岁（平均 10 岁零 10 个月；SD 5 岁零 11 个月），代表所有粗大运动功能分类量表 (GMFCS) 水平。 3 年期间，55 名（11.4%）参与者总共 186 次因呼吸道疾病住院，住院时间总计 1475 天。在单变量分析中，3年内后续呼吸道疾病入院的统计学显着危险因素为GMFCS V级、调查前一年至少一次呼吸道疾病入院、口咽吞咽困难、癫痫发作、频繁呼吸道症状、胃食管反流病、调查前一年至少使用过两个疗程的抗生素、进餐时呼吸道症状和夜间打鼾。结论 呼吸道疾病入院的大多数危险因素是潜在可改变的。及早识别口咽吞咽困难并治疗癫痫发作可能有助于预防严重的呼吸道疾病。一次呼吸道疾病入院应引发进一步的评估和管理，以预防随后的呼吸道疾病。
Objective To determine the early predictors of respiratory hospital admissions in young people with cerebral palsy (CP).Design A 3-year prospective cohort study using linked data.Patients Children and young people with CP, aged 1 to 26 years.Main outcome measures Self-reported and carerreported respiratory symptoms were linked to respiratory hospital admissions (as defined by the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) during the following 3 years.Results 482 participants (including 289 males) were recruited. They were aged 1 to 26 years (mean 10 years, 10 months; SD 5 years, 11 months) at the commencement of the study, and represented all Gross Motor Function Classification Scale (GMFCS) levels. During the 3-year period, 55 (11.4%) participants had a total of 186 respiratory hospital admissions, and spent a total of 1475 days in hospital. Statistically significant risk factors for subsequent respiratory hospital admissions over 3 years in univariate analyses were GMFCS level V, at least one respiratory hospital admission in the year preceding the survey, oropharyngeal dysphagia, seizures, frequent respiratory symptoms, gastro-oesophageal reflux disease, at least two courses of antibiotics in the year preceding the survey, mealtime respiratory symptoms and nightly snoring.Conclusions Most risk factors for respiratory hospital admissions are potentially modifiable. Early identification of oropharyngeal dysphagia and the management of seizures may help prevent serious respiratory illness. One respiratory hospital admission should trigger further evaluation and management to prevent subsequent respiratory illness.