某儿童医院肺炎30天内非计划再入院率风险因素调查  

Investigation on Risk Factors of Unplanned Readmission Rate within 30 Days of Pneumonia in a Children’s Hospital

作　　者：王淼[1] 周书雯 周丽 陈科[2] 张妍[2] Wang Miao;Zhou Shuwen;Zhou Li;Chen Ke;Zhang Yan(Shanghai Children’s Hospital,Shanghai Jiao Tong University,Shanghai 200062,China;不详)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院,上海市200062 [2]上海市计划生育科学研究所,上海市200032

出　　处：《中国病案》2021年第10期53-57,共5页Chinese Medical Record

基　　金：上海市卫生健康委员会科研项目(201740108)。

摘　　要：目的通过病案数据库结合病例对照研究对某儿童医院肺炎30天内非计划再入院率及常见风险因素进行初步探索,为指导临床健康宣教、提高患儿和家长相关预防意识提供依据。方法研究对象为某院2015年1月1日-2017年12月31日收住院的13013例非计划再入院普通社区获得性肺炎患儿,从中筛查获取30天内再入院情况之后,参考病例对照研究方法,建立再入院组和对照组各195例,对两组患儿及家长进行调查,比较两组特征和风险因素的差异,探索与发生再入院可能有关的因素。结果肺炎30天内再入院率为1.9%,与对照组相比,再入院患儿来自呼吸科比例较高(54.9%vs34.9%),有湿疹或紫癜史的比例较高(37.9%vs27.7%),有哮喘史的比例较高(19.5%vs11.8%),一年内呼吸道感染次数≥2次的比例较高(57.9%vs46.7%),营养不良中高风险的比例较高(11.8%vs6.7%),监护人低学历的比例较高(24.1%vs12.8%),其中呼吸科住院、哮喘史、营养风险、监护人低学历在多元分析中具有统计学意义。结论呼吸科住院、哮喘史、营养风险、监护人低学历可能与儿童肺炎30天内再入院的发生有关,结合现有临床研究证据,加强体质锻炼、减少呼吸道感染、监测与增强营养水平、提高患儿与家长的健康知识水平可能对降低肺炎再入院率水平起到促进作用。Objective Using hospitalized database and case-control method to explore common factors and their effect on 30-day unplanned readmission rate of pediatric pneumonia,to provide a basis for guiding clinical health education and improving the prevention awareness of children and parents.Methods The subjects were 13013 children with common community-acquired pneumonia registered in the database from January 1,2015 to December 31,2017.After screening for 30-day readmission occurrence in the pneumonia hospital records,a readmission group and a control group(both 195 cases)were investigated to compare the characteristics and risk factors between the two groups and to explore the possible factors related to readmission.Results 30-day readmission rate of common pneumonia in this hospital was 1.9%.Compared with control group,children of readmission were more from respiratory department(54.9%vs 34.9%),more had eczema or purpura history(37.9%vs 27.7%),more had asthma history(19.5%vs 11.8%),more had respiratory infection≥2 times per year(57.9%vs 46.7%),more had medium or high nutrition deficiency risk(11.8%vs 6.7%)and more lives with parents who had lower education level(24.1%vs 12.8%).Among these factors,hospitalization from respiratory department,asthma history,nutrition deficiency and parents with lower education level also showed correlation with readmission in multi-variant analysis.Conclusion Respiratory hospitalization,asthma history,nutritional risk and low educational background of guardians may be related to the re-admission of children with pneumonia within 30 days.Combined with the existing clinical research evidence,strengthening physical exercise,reducing respiratory tract infection,monitoring and enhancing nutrition level,and improving the health knowledge level of children and parents may play a role in reducing the re-admission rate of pneumonia.

关 键 词：儿童肺炎 重复入院 风险 非计划再入院 

分 类 号：R725.6[医药卫生—儿科]