在第三级护理环境中评估源不明的发烧定义:对诊断标准修订的影响
Pathik Dhangar1, Prasan Kumar Panda2, Ravi Kant1
1Department of Medicine, All India Institute of Medical Sciences, Rishikesh 249203, Uttarākhand, India.
World journal of experimental medicine
|June 23, 2025
概括
经过修订的未知起源发烧 (FUO) 标准,适应印度的当地环境,显示出更好的诊断效用. 定义B在40.8%的病例中占主导地位,在这种环境中证明了实际应用.
科学领域:
- 内部医学 内部医学
- 传染性疾病 传染性疾病
- 临床流行病学临床流行病学
背景情况:
- 未知来源的发烧 (FUO) 诊断仍然具有挑战性,经典标准是在1961年建立的.
- 现有的FUO定义可能无法充分解决印度等资源有限的环境中的各种临床表现.
- 在当地调整FUO标准对于准确的诊断和改善患者的治疗结果至关重要.
研究的目的:
- 评估修订后的FUO标准在印度一家三级医院的适用性.
- 在印度背景下,比较经典与适应的FUO定义的诊断产量.
主要方法:
- 这是一项从2018年1月到2022年12月在瑞士艾滋病医院进行的纵向探索性研究.
- 对228名发烧 (≥99.1°F) 超过三天的成年患者的分析,不包括入院后三天内诊断的患者.
- 采用预定义的FUO标准,基于发烧持续时间,温度和住院时间的回顾性和前性数据收集;统计分析包括费舍尔的精确和奇平方测试.
主要成果:
- 修订后的B定义 (发烧3-21天,99.1°F-100.9°F,住院>7天) 是最常见的 (40.8%),与符合经典标准的2.2%相比.
- 尽管进行了广泛的治疗,但36.5%的B定义患者在7-10天后仍未被诊断出来.
- 感染是主要病因;在定义之间没有观察到结果或死亡率的显著差异.
结论:
- 调整FUO标准可以提高当地诊断的准确性和治疗的有效性.
- 定义B被证明是实际的,确定了一个重要的患者队列.
- 在经验性抗结核治疗后出院的患者中,死亡率较高.
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