J Paediatr Child Health:儿童急性咳嗽的负担和急诊管理

2018-08-12 MedSci MedSci原创

在急诊室(ED)患急性咳嗽疾病的儿童中,本研究旨在:(i)描述其就诊次数和用药次数; (ii)描述管理并将其与现行的循证指南联系起来。在一家教学医院(澳大利亚布里斯班皇家儿童医院)行ED横断面研究。参与者包括537名患有急性(<2周)咳嗽的儿童(<15岁),中位年龄为2.2岁(四分位数间距为1.0-4.0); 61.5%是男生。住院儿童和患有哮喘,肺炎或慢性疾病的儿童被排除在外。主要结

在急诊室(ED)患急性咳嗽疾病的儿童中,本研究旨在:(i)描述其就诊次数和用药次数; (ii)描述管理并将其与现行的循证指南联系起来。

在一家教学医院(澳大利亚布里斯班皇家儿童医院)行ED横断面研究。参与者包括537名患有急性(<2周)咳嗽的儿童(<15岁),中位年龄为2.2岁(四分位数间距为1.0-4.0); 61.5%是男生。住院儿童和患有哮喘,肺炎或慢性疾病的儿童被排除在外。主要结果指标是:(i)ED前医生就诊次数和用药次数; (ii)将管理与目前基于证据的建议进行比较,这些建议涉及四种出院诊断:细支气管炎,喘息/反应性气道疾病(RAD),哮喘和“非特异性急性呼吸道疾病”。

结果,共有300名儿童(55.9%)在ED就诊前曾就医,并且ED前使用药物的比例很高(53.4%)。虽然93.4%的哮喘患儿按照指南进行治疗,但毛细支气管炎或'喘息/ RAD'患儿的一致性较低。大多数出院诊断为'wheeze / RAD'的儿童(95.6%)接受了支气管扩张剂,72.7%的儿童也接受了口服皮质类固醇但未被诊断为哮喘。超过一半(55.1%)的非特异性急性呼吸道疾病患儿在ED就诊前或就诊期间接受了药物治疗。

综上所述,该研究结果表明,儿童急性咳嗽相关疾病的负担很高,需要改进对循证指南的采用。此外,大量被诊断患有'喘息/RAD'的儿童表明哮喘在此医院可能被诊断不足。

原始出处:

Anderson-James S, Marchant JM, et al., Burden and emergency department management of acute cough in children. J Paediatr Child Health. 2018 Aug 1. doi: 10.1111/jpc.14146.


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level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52585, encryptionId=77b4525857d, topicName=急诊管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989231676378, createdName=12498b3em18(暂无昵称), createdTime=Wed Jul 03 09:47:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489836, encodeId=644514898362c, content=<a href='/topic/show?id=bcd5204ea9' target=_blank style='color:#2F92EE;'>#AED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2047, encryptionId=bcd5204ea9, topicName=AED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0108610571, createdName=makuansheng, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621742, encodeId=e3391621e42a4, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338172, encodeId=ca543381e2b4, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Aug 12 18:58:52 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2018-12-17 shizhenshan
  5. [GetPortalCommentsPageByObjectIdResponse(id=1975687, encodeId=ae6119e568746, content=<a href='/topic/show?id=222852245f1' target=_blank style='color:#2F92EE;'>#急性咳嗽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52245, encryptionId=222852245f1, topicName=急性咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cdcd18, createdName=bshuang, createdTime=Thu Sep 27 23:47:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638722, encodeId=1f2a1638e22dc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, 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level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52585, encryptionId=77b4525857d, topicName=急诊管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989231676378, createdName=12498b3em18(暂无昵称), createdTime=Wed Jul 03 09:47:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489836, encodeId=644514898362c, content=<a href='/topic/show?id=bcd5204ea9' target=_blank style='color:#2F92EE;'>#AED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2047, encryptionId=bcd5204ea9, topicName=AED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0108610571, createdName=makuansheng, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621742, encodeId=e3391621e42a4, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338172, encodeId=ca543381e2b4, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Aug 12 18:58:52 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2019-06-05 docwu2019
  6. [GetPortalCommentsPageByObjectIdResponse(id=1975687, encodeId=ae6119e568746, content=<a href='/topic/show?id=222852245f1' target=_blank style='color:#2F92EE;'>#急性咳嗽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52245, encryptionId=222852245f1, topicName=急性咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cdcd18, createdName=bshuang, createdTime=Thu Sep 27 23:47:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638722, encodeId=1f2a1638e22dc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, 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level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52585, encryptionId=77b4525857d, topicName=急诊管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989231676378, createdName=12498b3em18(暂无昵称), createdTime=Wed Jul 03 09:47:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489836, encodeId=644514898362c, content=<a href='/topic/show?id=bcd5204ea9' target=_blank style='color:#2F92EE;'>#AED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2047, encryptionId=bcd5204ea9, topicName=AED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0108610571, createdName=makuansheng, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621742, encodeId=e3391621e42a4, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338172, encodeId=ca543381e2b4, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Aug 12 18:58:52 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
  7. 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href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338172, encodeId=ca543381e2b4, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Aug 12 18:58:52 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2018-08-14 makuansheng
  8. 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level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52585, encryptionId=77b4525857d, topicName=急诊管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989231676378, createdName=12498b3em18(暂无昵称), createdTime=Wed Jul 03 09:47:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489836, encodeId=644514898362c, content=<a href='/topic/show?id=bcd5204ea9' target=_blank style='color:#2F92EE;'>#AED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2047, encryptionId=bcd5204ea9, topicName=AED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0108610571, createdName=makuansheng, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621742, encodeId=e3391621e42a4, content=<a 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time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1975687, encodeId=ae6119e568746, content=<a href='/topic/show?id=222852245f1' target=_blank style='color:#2F92EE;'>#急性咳嗽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52245, encryptionId=222852245f1, topicName=急性咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cdcd18, createdName=bshuang, createdTime=Thu Sep 27 23:47:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638722, encodeId=1f2a1638e22dc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, 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level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52585, encryptionId=77b4525857d, topicName=急诊管理)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=989231676378, createdName=12498b3em18(暂无昵称), createdTime=Wed Jul 03 09:47:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489836, encodeId=644514898362c, content=<a href='/topic/show?id=bcd5204ea9' target=_blank style='color:#2F92EE;'>#AED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2047, encryptionId=bcd5204ea9, topicName=AED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0108610571, createdName=makuansheng, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621742, encodeId=e3391621e42a4, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Tue Aug 14 07:47:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338172, encodeId=ca543381e2b4, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun Aug 12 18:58:52 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2018-08-12 清风拂面

    谢谢分享学习

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1975687, encodeId=ae6119e568746, content=<a href='/topic/show?id=222852245f1' target=_blank style='color:#2F92EE;'>#急性咳嗽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52245, encryptionId=222852245f1, topicName=急性咳嗽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cdcd18, createdName=bshuang, createdTime=Thu Sep 27 23:47:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638722, encodeId=1f2a1638e22dc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, 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time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338170, encodeId=2c673381e06f, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Sun Aug 12 18:26:51 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2018-08-12 orangesking

    0