对败血症手腕的预测因素的评估,以避免过度诊断
Ying C Ku1, Mazen Al-Malak1, Mychajlo S Kosyk1
1Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland 44195, OH, USA.
概括
鉴于非特定的标准,诊断败血症手腕可能具有挑战性. 关键指标,如阴性突结晶和阳性血培养,有助于区分败血性手腕与其他手腕疾病.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 败血性手腕诊断往往是不特定的,导致非传染性手腕疾病患者不必要的手术.
- 识别出败血症手腕的准确预测因素对于避免错误诊断患者的手术发病率至关重要.
研究的目的:
- 确定临床和实验室预测因子,区分败血性手腕和其他手腕病理.
- 提高诊断准确度,减少手腕非传染性疾病的手术干预.
主要方法:
- 从2003年到2022年,对168名怀疑有败血症手腕的患者进行了回顾性审查.
- 两变和多重回归分析被用于与各种临床因素和实验室标记器相关联的败血性手腕.
- 分析的关键因素包括并发症,创伤史,发烧,关节干扰,炎症标志物 (ESR,CRP,WBC) 和结膜液分析.
主要成果:
- 在168名患者中,53%的患者确诊有败血症,29%的患者接受了替代诊断,18%的患者有未确定的诊断.
- 败血症手腕的预测因素包括阴性突晶体 (p=0.01),阳性血液培养 (p=0.04),阴性结晶关节病史 (p=0.08) 和多关节干扰 (p=0.05).
- 这些预测因素的综合灵敏度为87.5%,特异性为86.2% (AUC 0.93).
结论:
- 现有的败血症手腕的诊断标准缺乏特异性.
- 缺少突结晶,阳性血培养,缺乏结晶性关节病史,多关节参与是败血性手腕的重要预测因素.
- 这些发现可以帮助在患有疼痛,胀和红血性手腕的患者中区分败血性手腕.
关键词:
手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手术手 ...管理 管理 管理 管理预测者 预测者消毒性手腕关节炎 消毒性手腕关节炎手腕炎症 手腕炎症
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