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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Home syrup of ipecac use does not reduce emergency department use or improve outcome.
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Home syrup of ipecac use does not reduce emergency department use or improve outcome.

机译：吐根使用家庭糖浆不会减少急诊科的使用或改善结局。

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BACKGROUND: The usefulness of syrup of ipecac as a home treatment for poisoning and the need to keep it in the home has been increasingly challenged. Many poison centers do not recommend any use of syrup of ipecac. OBJECTIVE: To determine if use of syrup of ipecac in children at home is associated with reduced utilization of emergency department (ED) resources or improved outcome after unintended exposure to a pharmaceutical. DESIGN: Cohort comparison. SETTING: American Association of Poison Control Centers' Toxic Exposure Surveillance System Database. PATIENTS: Blinded data for each of the 64 US poison centers included ED referral recommendation rate, actual rate of ED use, actual home use of syrup of ipecac, and outcome. These data were derived from cases in 2000 and 2001 involving children <6 years of age who unintentionally ingested a pharmaceutical agent and in which the call to a poison center came from home (752 602 children). OUTCOME MEASURES: Correlation between rate of home use of syrup of ipecac and rate of recommendation for ED referral was the primary outcome sought. Rate of adverse outcome was also compared. In addition, the actual ED use and home syrup of ipecac utilization rates at 7 specific centers were identified and compared with the published rates from these same centers from 1990 data to look for the trend in practice for this subgroup. RESULTS: Mean rate of referral to ED was 9% (range: 3%-18%). Mean home use of syrup of ipecac was 1.8% (range: 0.2%-14%). Increased home use of syrup of ipecac was not associated with referral to ED (r = 0.18; 95% confidence interval of r = -0.06-0.41). Adverse outcome was rare: 0.6% (range: 0.2%-2.1%). There was no difference in referral rate or adverse outcome rate between 2 groups of 32 centers divided by relative syrup of ipecac use. In the 7 centers, ED use decreased from a mean of 13.5% in 1990 to a mean of 8.1% in 2000-2001. Ipecac use decreased from a mean of 9.6% to 2.1%. CONCLUSIONS: This study suggests there is no reduction in resource utilization or improvement in patient outcome from the use of syrup of ipecac at home. Although these data cannot exclude a benefit in a very limited set of poisonings, any benefit remains to be proven.
机译：背景：吐根糖浆作为中毒家庭疗法的实用性以及将其保存在家里的需求日益受到挑战。许多毒物中心不建议使用任何吐根糖浆。目的：确定在家中儿童中使用吐根糖浆是否与急诊科（ED）资源使用减少或意外接触药物后改善结局有关。设计：同类群组比较。地点：美国毒物控制中心协会的有毒暴露监测系统数据库。患者：美国64个毒物中心的盲数据包括ED推荐率，ED的实际使用率，吐根糖浆的实际家庭使用率和预后。这些数据来自2000年和2001年的案例，这些案例涉及6岁以下的儿童，这些儿童无意中摄入了药物，并且在家中呼叫毒物中心（752 602名儿童）。观察指标：吐根糖浆的家庭使用率与急诊科转诊推荐率之间的相关性是所寻求的主要结果。还比较了不良结局发生率。此外，确定了7个特定中心的实际ED使用量和吐根的家庭糖浆利用率，并将其与1990年数据从这些中心发布的比率进行了比较，以寻找该亚组在实践中的趋势。结果：ED的平均转诊率为9％（范围：3％-18％）。吐根糖浆的家庭平均使用率为1.8％（范围：0.2％-14％）。吐根糖浆的家庭增加使用与转诊急诊并不相关（r = 0.18; 95％置信区间r = -0.06-0.41）。不良结果很少见：0.6％（范围：0.2％-2.1％）。 2组的32个中心之间的转诊率或不良结局发生率除以吐根使用的相对糖浆无差异。在这七个中心中，ED的使用从1990年的平均13.5％下降到2000-2001年的8.1％。 Ipecac的使用率从9.6％的平均水平降低到2.1％。结论：这项研究表明在家中使用吐根糖浆不会减少资源利用或改善患者预后。尽管这些数据不能排除在非常有限的一次中毒中的益处，但是任何益处仍有待证明。

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