Initial Modified Pulmonary Index Score Predicts Hospital Length of Stay for Asthma Subjects Admitted to the Pediatric Intensive Care Unit.
ackground: Scoring systems are frequently used to assess the severity of pediatric asthma exacerbations. The modified pulmonary index score (MPIS) has been found to be highly correlated with length of stay (LOS) in the pediatric intensive care unit (PICU). We sought to evaluate the use of the MPIS t...
| Publicado en: | Respiratory Care Vol. 65; no. 9; pp. 1227 - 1233 |
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| Autores principales: | , , , , , , |
| Formato: | CEU research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145308231&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145308231 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Sep2020 vid: 65 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 145308231 145308231 145308231 10.4187/respcare.07396 145308231 ppf: 1227 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Initial Modified Pulmonary Index Score Predicts Hospital Length of Stay for Asthma Subjects Admitted to the Pediatric Intensive Care Unit. aug: au: Miller, Andrew G. Haynes, Kaitlyn E. Gates, Rachel M. Zimmerman, Kanecia O. Bartlett, Kathleen W. McLean, Heather S. Rehder, Kyle J. affil: Respiratory Care Services, Duke University Medical Center, Durham, North Carolina sug: subj: Intensive Care Units, Pediatric Asthma Prognosis Length of Stay Evaluation Predictive Value of Tests Evaluation Education, Continuing (Credit) Human Male Female Child, Preschool Child Retrospective Design Record Review Albuterol Therapeutic Use Nasal Cannula Respiration, Artificial Oxygen Therapy Methods Status Asthmaticus Descriptive Statistics Data Analysis Software Chi Square Test One-Way Analysis of Variance Regression Continuous Positive Airway Pressure Respiratory Rate Heart Rate Severity of Illness Indices Child, Preschool: 2-5 years Child: 6-12 years Male Female ab: ackground: Scoring systems are frequently used to assess the severity of pediatric asthma exacerbations. The modified pulmonary index score (MPIS) has been found to be highly correlated with length of stay (LOS) in the pediatric intensive care unit (PICU). We sought to evaluate the use of the MPIS to predict hospital LOS for patients admitted to our PICU. Methods: We retrospectively reviewed the medical records of pediatric asthma subjects aged 2-17 y admitted to our PICU between June 2014 and November 2017. We divided subjects a priori into 3 groups (low: MPIS 0-5; medium: MPIS 6-9; high: MPIS ≥ 10) based upon each subject's first MPIS documented in the PICU. Hospital LOS, PICU LOS, time on continuous albuterol, and increased respiratory support were compared between groups. Results: 143 subjects were included. There were no differences for demographics, medical history, cause of exacerbations, or mean heart rate between groups. There were significant differences between groups for mean breathing frequency (P < .001), S... (P = .01), and F... (P < .004). There were significant differences between groups for route of admission (P = .02), high-flow nasal cannula use (P < .001), and use of a helium-oxygen mixture (P < .001). There were significant differences between groups for median hospital LOS (1.2 vs 2.3 vs 3.4 d, P < .001), PICU LOS (0.39 vs 1.3 vs 2 d, P < .001), and time on continuous albuterol (7.4 vs 20.6 vs 34.7 h, P < .001). After adjusting for demographics and medical history, the incidence risk ratio for hospital LOS was 2.09 for PICU admission for an MPIS of 6-9 and 2.68 for an MPIS ≥ 10 when compared to an MPIS < 6. Conclusions: The MPIS thresholds used in our pathway appropriately predicted LOS in our cohort of subjects with asthma admitted to the PICU. Higher MPIS was associated with increased hospital LOS, PICU LOS, and time on continuous albuterol. pubtype: Academic Journal doctype: CEU research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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