儿童骨和关节感染的诊断延迟
Sarah Hunter1, Elsie Brown2, Haemish Crawford1
1Faculty of Medical and Health Sciences, The University of Auckland; Paediatric Orthopaedic Department, Starship Children's Hospital.
The New Zealand medical journal
|May 1, 2025
概括
在儿童骨关节感染 (BJI) 中,延迟诊断很常见,导致治疗时间更长. 早期识别对于急性骨髓炎和败血性关节炎的更好的结果至关重要.
科学领域:
- 儿童传染病 儿童传染病
- 肌肉骨感染 肌肉骨感染
- 诊断的准确性 诊断的准确性
背景情况:
- 儿童急性骨关节感染 (BJI),包括急性血源性骨髓炎 (AHO) 和败血性关节炎 (SA),带来了重大诊断挑战.
- 延迟诊断可能会对患者的结果产生负面影响,并增加医疗保健成本.
研究的目的:
- 为了确定儿童BJI病例中延迟诊断的发生率.
- 调查延迟诊断与急性儿童骨关节感染的疾病轨迹之间的关联.
主要方法:
- 在奥克兰地区,从2018年至2023年对患有AHO或SA的儿科患者 (<16岁) 的回顾性审查.
- 分析电子记录以确定BJI确认之前的初始替代诊断.
- BJI亚型的分类和主要结果评估,包括停留时间和住院费用.
主要成果:
- 在儿童BJI病例中,很大一部分 (43%) 得到了另一个初始诊断.
- 有替代诊断的儿童更有可能寻求初级/紧急护理,并经历病毒性疾病.
- 延迟诊断与延长治疗延迟 (7.8 vs 4 天) 和连续感染有关,需要更多的手术和更高的成本.
结论:
- 儿童AHO和SA的延迟识别很普遍,并导致治疗延迟.
- 超过一周的症状与连续感染相关,需要更多的手术干预,并与孤立的AHO相比承担更高的住院费用.
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