مورد إلكتروني
Effect of a standardized approach on infants hospitalized for apparent life threatening events
| العنوان: | Effect of a standardized approach on infants hospitalized for apparent life threatening events |
|---|---|
| عناروين إضافية: | Efecto de un enfoque estandarizado para el manejo de lactantes hospitalizados por eventos aparentemente letales |
| المصدر: | Biomedica; Vol. 38 No. 4 (2018); 479-485; Biomédica; Vol. 38 Núm. 4 (2018); 479-485; 2590-7379; 0120-4157 |
| بيانات النشر: | Instituto Nacional de Salud 2018-12-01 |
| تفاصيل مُضافة: | Zenteno, Daniel Peña, Rubén Fuentes, Claudia Tapia, Jaime Verbal, Daniela Rodríguez-Núñez, Iván |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Introduction: An apparent life-threatening event (ALTE) is a frequent cause of hospitalization in infants. However, there is little evidence about the existence of a standardized approach to discover the main etiology, although a correct causal diagnosis can affect clinical evolution, hospital stay, and health resources.Objective: To determine the effects of a standardized diagnostic approach in infants admitted with ALTE.Materials and methods: We conducted a retrospective cohort study with the data collected from clinical records of infants hospitalized for ALTE in the pediatric unit between 2002 and 2009. Two cohorts of patients were analyzed according to the procedures defined for these cases: Cohort 1 with clinical guidelines and cohort 2 with clinical guidelines, study protocol, and outpatient follow-up. Etiological causes, hospitalization periods and readmission rates were compared between both cohorts.Results: Of the 255 infants hospitalized for ALTE, 57.6% corresponded to cohort 1 and 42.3% to cohort 2. No differences were observed in age and gender between groups. The highest percentage of attributed causes (63.9 vs 87.0%; p<0.0001) and a shorter period of hospitalization (8.0 vs 5.0 days; p=0, 0001) were observed in cohort 2. No differences in hospital readmission were observed (10.5 vs 8.3 days; p=0.7435).Conclusions: The protocol-based approach for infants with EAL was associated with a higher percentage of recognition of attributed causes and a shorter hospitalization period. Therefore, our results allow recommending this type of standardization for the management of these patients. Introducción. Los eventos aparentemente letales (Apparent Life-Threatening Event, ALTE) son causa frecuente de hospitalización en lactantes. Hay poca información sobre el enfoque estandarizado para establecer su etiología, a pesar de que un diagnóstico causal correcto puede afectar la evolución clínica, la duración de la hospitalización y los recursos sanitarios.Objetivo. Comparar los efectos del enfoque diagnóstico estandarizado en lactantes hospitalizados por este tipo de eventos.Materiales y métodos. Se hizo un estudio retrospectivo de cohorte con base en los datos recolectados de las historias clínicas de lactantes hospitalizados por esta causa en el servicio de pediatría entre el 2002 y el 2009. Se analizaron dos cohortes de pacientes agrupados según su manejo: la cohorte 1, con guías clínicas, y la cohorte 2, con guías clínicas, protocolo de estudio y seguimiento ambulatorio. Se compararon los grupos en cuanto a la etiología, el tiempo de hospitalización y la tasa de nuevas hospitalizaciones.Resultados. De los 255 lactantes hospitalizados por eventos aparentemente letales, el 57,6 % integró la cohorte 1 y, el 42,3 %, la cohorte 2. No se observaron diferencias en cuanto a la edad y el sexo. En la cohorte 2 se observó un mayor porcentaje de causas atribuidas (63,9 Vs. 87,0; p<0,0001), y un menor tiempo de hospitalización (8,0 Vs. 5,0 días; p=0,0001). No hubo diferencias en cuanto a nuevas hospitalizaciones (10,5 Vs. 8,3 días; p=0,7435).Conclusiones. El enfoque del manejo de lactantes afectados por eventos aparente letales basado en protocolos, se asoció con un mayor porcentaje de reconocimiento de las causas atribuidas y con un menor período de hospitalización. A partir de estos resultados es posible sugerir la implementación de este tipo de estandarización para el manejo de dichos pacientes. |
| مصطلحات الفهرس: | Infant, infantile apparent life-threatening event, hospitalization, clinical protocols, apnea, lactante, evento de aparente amenaza a la vida infantil, hospitalización, protocolos clínicos, info:eu-repo/semantics/article, info:eu-repo/semantics/publishedVersion |
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| ملاحظة: | application/pdf text/xml Spanish |
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