Schaefer Franz, Kandert Marianne, Feneberg Reinhard
Division of Pediatric Nephrology, Children's Hospital, Ruperto-Carolus University, Heidelberg, Germany.
Perit Dial Int. 2002 Mar-Apr;22(2):234-8.
To evaluate the distribution of peritonitis incidence and assess the usefulness of patient-specific peritonitis rates in children.
49 children on automated peritoneal dialysis (PD) followed during a 2-year observation period.
Single-center, academic children's hospital.
49 children aged 2 months to 18 years; 24 prevalent, 25 incident during the observation period. Cumulative observation time was 639 patient-months.
Cohort-specific peritonitis incidence, median patient-specific peritonitis incidence, mean peritonitis incidence by gamma-Poisson (negative binomial) modeling, peritonitis-free survival by Kaplan-Meier life-table analysis.
68 new peritonitis episodes and 21 relapses occurred in 27 patients. The distribution of patient-specific peritonitis incidence was bimodal, with a large group experiencing no or very few episodes, and another cluster around 1 episode per 6-9 months. Overall cohort-specific peritonitis incidence was 1.28, median subject-specific incidence 0.99, and mean incidence according to negative binomial modeling 1.04 (95% confidence interval 1.02-1.06) episodes per patient-year. Median peritonitis-free survival time was 6.9 months. In those patients who developed peritonitis, subject-specific peritonitis incidence was inversely correlated with patient age (r = -0.42, p < 0.05) and duration of chronic PD at last observation (r = -0.42, p < 0.05).
Since the distribution of peritonitis in children is non-Gaussian, the average risk of peritonitis is more accurately expressed by the median of the individual subject-specific peritonitis rates or by the mean incidence estimate obtained by the negative binomial distribution model. The assignment of a personal peritonitis risk to each patient permits risk factor analysis by routine statistical methods, even in smaller populations.
评估儿童腹膜炎发病率的分布情况，并评估患者特异性腹膜炎发生率的实用性。
在2年观察期内对49例接受自动腹膜透析（PD）的儿童进行随访。
单中心学术儿童医院。
49例年龄在2个月至18岁之间的儿童；观察期内24例为现患患者，25例为新发病例。累计观察时间为639患者月。
队列特异性腹膜炎发病率、患者特异性腹膜炎发病率中位数、通过伽马-泊松（负二项式）模型计算的平均腹膜炎发病率、通过Kaplan-Meier生存表分析的无腹膜炎生存期。
27例患者发生68次新的腹膜炎发作和21次复发。患者特异性腹膜炎发病率分布呈双峰状，一大组患者无发作或发作极少，另一组约每6 - 9个月发作1次。整个队列特异性腹膜炎发病率为1.28，个体特异性发病率中位数为0.99，根据负二项式模型计算的平均发病率为每患者年1.04次（95%置信区间1.02 - 1.06）。无腹膜炎生存期中位数为6.9个月。在发生腹膜炎的患者中，个体特异性腹膜炎发病率与患者年龄（r = -0.42，p < 0.05）以及最后一次观察时慢性腹膜透析的持续时间（r = -0.42，p < 0.05）呈负相关。
由于儿童腹膜炎的分布并非高斯分布，个体特异性腹膜炎发生率的中位数或通过负二项式分布模型获得的平均发病率估计值能更准确地表达腹膜炎的平均风险。为每位患者确定个人腹膜炎风险，即使在较小的人群中，也可通过常规统计方法进行危险因素分析。
