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Patient-centered Interventional Outc...

Nelson, Katherine E.

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Patient-centered Interventional Outcomes for Children with Severe Neurologic Impairment.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Patient-centered Interventional Outcomes for Children with Severe Neurologic Impairment./
作者:	Nelson, Katherine E.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
面頁冊數:	212 p.
附註:	Source: Dissertations Abstracts International, Volume: 80-06, Section: B.
Contained By:	Dissertations Abstracts International80-06B.
標題:	Medicine. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10823798
ISBN:	9780438682139

Patient-centered Interventional Outcomes for Children with Severe Neurologic Impairment.
Nelson, Katherine E.

Patient-centered Interventional Outcomes for Children with Severe Neurologic Impairment. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 212 p.

Source: Dissertations Abstracts International, Volume: 80-06, Section: B.

Thesis (Ph.D.)--University of Toronto (Canada), 2018.

This item must not be sold to any third party vendors.

Decisions about surgical interventions for children with neurologic impairment are difficult for families, in part because of the limited evidence about outcomes. This thesis addresses three knowledge gaps about interventional outcomes in this population from varying perspectives. The included studies considered qualitative and quantitative outcomes after a specific intervention (feeding tube placement) in the broad population of children with neurologic impairment and evaluated outcomes after all surgical interventions in children with neurologic impairment caused by two specific genetic diagnoses (trisomy 13 and 18). First, in our qualitative systematic review of 13 studies describing family experiences after feeding tube placement for children with neurologic impairment, we found that feeding tube placement has diverse and variable effects on children and their families, with noted benefits and challenges. Second, in a study using health administrative data to evaluate healthcare utilization before and after feeding tube placement among children with neurologic impairment, we found that rates of unplanned hospitalization are stable during the two years after compared to the two years before the procedure (rate ratio 0.93 with 95% confidence interval: 0.62-1.41). This finding was consistent across a range of types of healthcare utilization (e.g., emergency room and outpatient visits) and across clinically relevant subgroups (e.g., children with and without anti-reflux procedures). Finally, we described survival and surgical interventions among children with neurologic impairment from trisomy 13 and 18. We found that a small subgroup of children (10-13%) survives a decade or more, and that children with trisomy 13 and 18 who undergo surgical interventions have high one-year survival (approximately 70%). These three studies inform important decision-making conversations between families of children with neurologic impairment and their clinicians.

ISBN: 9780438682139Subjects--Topical Terms:

641104
Medicine.

Patient-centered Interventional Outcomes for Children with Severe Neurologic Impairment.
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