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I Dipartimenti in Ospedale

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I Dipartimenti in Ospedale ATTIVITÀ SANITARIA E SCIENTIFICA 2019 INDICE PRESENTAZIONE 4 INTRODUZIONE 5 1 ATTIVITÀ SANITARIA 6 Attività assistenziali e indicatori di performance 7 Programma miglioramento continuo qualità dell’assistenza 28 2 ATTIVITÀ DEI DIPARTIMENTI 60 Dipartimento Chirurgico 62 Dipartimento Emergenza Accettazione e ARCO 67 Dipartimento Immagini 70 Dipartimento Laboratori 72 Dipartimento Medico Chirurgico di Cardiologia Pediatrica 75 Dipartimento Neonatologia Medica e Chirurgica 77 Dipartimento Neuroscienze e Neuroriabilitazione 81 Dipartimento Oncoematologia e Terapia Cellulare e Genica 84 INDICE Dipartimento Pediatrie Specialistiche 86 Dipartimento Pediatrico Universitario Ospedaliero 90 3 ATTIVITÀ SCIENTIFICA 96 Attività scientifica e indicatori di performance 97 Produzione scientifica 98 Attività di ricerca 100 Finanziamenti per la ricerca 104 Collaborazioni scientifiche 106 Trasferimento Tecnologico 108 Formazione e Accreditamento ECM 109 4 BIBLIOTECA MEDICA 112 5 RISULTATI SCIENTIFICI SIGNIFICATIVI NELLE RIVISTE A PIÙ ELEVATO FATTORE DI IMPATTO 116 6 STRUTTURE INNOVATIVE PER LA RICERCA 120 Media, ricerca e innovazione in OPBG 121 Il Nuovo Sequenziatore Novaseq 6000 System 123 Tecnologia 3D 124 Nuova tecnologia per studiare le epilessie sul tessuto cerebrale umano 125 Biobanca 126 Officina Farmaceutica 129 7 AREE DI RICERCA 132 Area di Ricerca Genetica e Malattie Rare 134 Area di Ricerca Malattie Multifattoriali e Malattie Complesse 146 Area di Ricerca Immunologia 154 Area di Ricerca Infettivologia e Sviluppo di Farmaci Pediatrici 159 Area di Ricerca Oncoematologia 166 Area di Ricerca Innovazioni Clinico Gestionali e Tecnologiche 177 8 PUBBLICAZIONI SCIENTIFICHE 188 Pubblicazioni 189 PRESENTAZIONE «La riconoscenza della Repubblica» per quanto la comunità dell’ospedale ha realizzato nella sua storia è forse l’apprezzamento più importante che è stato attribuito al nostro ospedale nel corso di questo intenso 2019, anno delle celebrazioni per il 150° anniversario della fondazione. Nelle parole del Presidente Sergio Mattarella, in visita nella sede di San Paolo nel giorno del compleanno dell’Ospedale, il 19 marzo, sentiamo commossi il riconoscimento per l’impegno profuso ancora oggi, ogni giorno, nell’assistenza dei bambini e dei ragazzi, nella ricerca scientifica, nella tensione verso la qualità e la sicurezza delle cure. Una tensione e un impegno che ci hanno portato a inaugurare simbolicamente il nostro anniversario nella capitale della Repubblica Centrafricana, a Bangui, dove abbiamo aperto questo anno il Centro per i bambini malnutriti voluto da Papa Francesco, per offrire una struttura pediatrica di eccellenza in uno dei paesi più poveri del mondo. È stata un’occasione che ci ha permesso di valorizzare la nostra antica missione: curare i piccoli infermi. Oggi ci mettiamo, in modo nuovo, al servizio dei figli del mondo attraverso la diffusione e la condivisione delle conoscenze mediche e delle pratiche terapeutiche. Lo scorso anno, come dimostra questo volume, le nostre attività sono proseguite per offrire i migliori percorsi di cura ai ragazzi e ai bambini che assistiamo con il supporto della ricerca scientifica e delle innovazioni tecnologiche e strutturali. Ne è un esempio la ristrutturazione della sede di Viale Baldelli, con le attività ambulatoriali legate alle malattie rare e ai centri per l’anoressia e l’autismo. Nel 2019 abbiamo superato abbondantemente le 2 milioni di prestazioni ambulatoriali, non era mai accaduto nella nostra storia. Sempre lo scorso anno abbiamo raggiunto e poi superato lo storico traguardo dei 1000 trapianti di organi solidi. Sono trascorsi appena 34 anni da quando realizzammo il primo: era il 1986 ed il piccolo Ivan riceveva il suo nuovo cuore. È cresciuta, nell’ultimo anno, la complessità della casistica ed è cresciuto il valore della ricerca scientifica, svolta in collaborazione con Università e Istituti di ricerca di oltre 100 paesi nel mondo. La comunità internazionale è fondamentale per esplorare le nuove frontiere della medicina e trovare percorsi terapeutici innovativi, sempre più calibrati sulle esigenze del singolo paziente, grazie anche alla ricchezza delle informazioni sul patrimonio genetico che riusciamo ad ottenere con le nuove tecnologie acquisite nel corso dell’anno. Come sempre, i tanti risultati illustrati nelle pagine che seguono nascondono la cifra della passione e della dedizione delle persone che vivono quotidianamente l’ospedale. Ne conservo un’immagine precisa, tra i miei ricordi di quest’anno: il momento in cui Papa Francesco, durante l’udienza del 17 novembre nell’aula San Paolo VI, ha benedetto le mani dei medici e degli infermieri presenti. Quell’emozione rimarrà indelebile nei cuori di tutti noi. Mariella Enoc Presidente Ospedale Pediatrico Bambino Gesù 4 ATTIVITÀ SANITARIA E SCIENTIFICA 2019 INTRODUZIONE Il 2019 è stato un anno speciale per l’Ospedale Bambino Gesù (OPBG). Il 19 marzo è stata celebrata, alla presenza del Segretario di Stato Vaticano e del Presidente della Repubblica Italiana, la ricorrenza del 150° anniversario della nostra fondazione. I compleanni hanno un valore simbolico, ma sono anche un’occasione per riflettere. Nel caso specifico, per rivisitare un lungo percorso di crescita e di successi, che hanno trasformato il primo piccolo Ospedale pediatrico nato a Roma nel 1869 in via delle Zoccolette, nel più grande Ospedale dei bambini d’Europa, un Istituto all’avanguardia nell’assistenza e nella ricerca. Assistenza e ricerca sono le pietre angolari delle attività dell’OPBG, riaffermate negli ultimi 35 anni con la classificazione ad Istituto di Ricovero e Cura a Carattere Scientifico, un riconoscimento, confermato nel 2019, che ne sottolinea l’impegno nelle attività cliniche di eccellenza e nello sviluppo di ricerche traslazionali, destinate a produrre risultati fruibili dai pazienti in tempi ragionevolmente brevi. Il significato valoriale delle due anime dell’OPBG, espresse nell’integrazione tra assistenza e ricerca, è supportato dall’evidenza di una diretta proporzionalità tra la qualità delle ricerche svolte nell’Ospedale e la qualità dell’assistenza erogata ai pazienti. La ricerca sanitaria è sinonimo di speranza, in quanto strumento potenzialmente in grado di identificare soluzioni idonee a migliorare la diagnosi delle malattie, a prevenirle e a rendere più efficace la presa in carico e la terapia. In armonia con queste finalità, l’Ospedale ha allineato una parte sostanziale delle proprie attività e risorse alla rivoluzione culturale, scientifica e tecnologica, che domanda importanti investimenti strutturali, strumentali e di capitale umano. Sostenuto da questa ambiziosa visione, l’OPBG è proiettato nel futuro, verso quella medicina dei sistemi nella quale l’integrazione tra i dati clinici, strumentali, genetici e di laboratorio, attraverso avanzate piattaforme informatiche, promette di dare concretezza ad un vecchio adagio della medicina, “esistono i malati, non esistono le malattie”, riscoprendo così l’unicità di ogni persona e la conseguente possibilità di non fare più riferimento ai pazienti come a dei numeri all’interno di protocolli, ma piuttosto adattando le terapie ai loro specifici profili biologici. I risultati di questo percorso sono evidenziati dai numeri espressi dalle attività cliniche e scientifiche dell’Ospedale nell’anno 2019, che trovano una sintesi in questo volume redatto a due mani dalla Direzione Sanitaria e dalla Direzione Scientifica. Nell’ambito clinico e assistenziale l’Ospedale ha presentato una ulteriore crescita nella numerosità e nella complessità della casistica (rispettivamente + 2% e +4% rispetto all’anno precedente). Attraverso questi numeri si percepisce la misura di quanto OPBG abbia consolidato il proprio ruolo di leadership a livello nazionale ed internazionale nell’assistenza e cura dei pazienti pediatrici. Un primo dato di grande interesse è rappresentato dalla presa in carico del paziente e delle famiglie, garantita dalle attività del Servizio Sociale, che nell’anno 2019 ha seguito in totale 1.926 pazienti, di cui il 45% è rappresentato da stranieri. Per questi pazienti l’intervento degli Assistenti Sociali è stato diretto a garantire supporto informativo sugli aspetti di tutela della salute e a favorire percorsi di inclusione ed integrazione sociale sul territorio italiano. Al fine di rispondere in modo adeguato alle esigenze dei pazienti e delle famiglie, l’Ospedale negli anni ha perseguito una politica di riduzione dei ricoveri erogati in regime diurno medico (-30% negli ultimi otto anni) a vantaggio dell’offerta di attività ambulatoriale (+85% negli ultimi otto anni), privilegiando, anche in ottemperanza al dettato normativo regionale, modelli organizzativi orientati all’appropriatezza clinica, che hanno consentito di trasferire significative quote di prestazioni dispensate in day hospital in un regime a minore intensità, ma di analoga efficacia assistenziale, quale quello ambulatoriale. Per tale ragione nel 2019 è stato ristrutturato il Centro di Viale Baldelli, sede dedicata alle attività ambulatoriali dal 1995. Tale ristrutturazione ha consentito di dedicare nuovi spazi alle attività ambulatoriali per una più adeguata accoglienza dei pazienti che presentano condizioni complesse e di elevata specialità. A queste peculiari tipologie di pazienti l’Ospedale ha dedicato il Centro per l’Autismo e le reti ERN, reti internazionali cui afferiscono Centri altamente specializzati, in un’ottica di miglioramento delle cure di tutti i pazienti dell’Unione europea che soffrono di un a malattia rara (ERN - European
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