Pelisse M, Barasso R
Cabinet de Dermatologie, Paris.
Ann Dermatol Venereol. 2003 Nov;130(11):1003-7.
The treatment of condylomata acuminata relies on prolonged management, partly related to the need for repeated applications with regard to destructive therapeutic measures and the clinical supervision because of the high prevalence of relapses. This implies that patients are ready to consult their doctor at regular intervals during a relatively prolonged period of time. We wanted to assess the patients lost to follow-up in a population of patients exhibiting anogenital warts together with the factors associated with the loss to follow-up.
This was a prospective observational study conducted in France among dermatologists and gynecologists between May and December 2000. The physicians were free to prescribe the treatment of their choice. The social data of the patients and the classical characteristics of the condylomata acuminata were assessed. A patient was considered as lost to follow-up when he/she no longer came in for the consultation assessing the treatment. The data of the patients lost to follow-up were compared to those of the other patients.
Two hundred ninety-seven cases, with 57 p. 100 men, were included during the study period. The mean age of the patients was of 33.8 +/- 11.4 years, with 43 p. 100 of patients aged under 30. In 40 p. 100 of cases, the lesions had existed for more than 3 months and were symptomatic in 30 p. 100 of cases. At the end of the study, 28.3 p. 100 of patients were considered as lost to follow-up. With multivariate analysis, the loss to follow-up appeared related to the patients' age (more frequent, the younger the patient; p<0.04) and not to the fixing of a precise appointment at the end of treatment (p<0.001). The asymptomatic nature of the lesions, recognized as a loss to follow-up risk factor in univariate analysis, was at the limit of significance in multivariate analysis (p=0.06).
Clinicians should be particularly attentive with young and asymptomatic patients that they treat for condylomata acuminata, and attempt to reduce the rate of lost to follow-up and improve the quality of their management.
尖锐湿疣的治疗依赖于长期管理，部分原因是由于破坏性治疗措施需要反复应用以及复发率高需要临床监测。这意味着患者要在相对较长的一段时间内定期咨询医生。我们想评估一群患有肛门生殖器疣的患者中失访的患者以及与失访相关的因素。
这是一项于2000年5月至12月在法国皮肤科医生和妇科医生中进行的前瞻性观察研究。医生可自由选择他们所开的治疗方法。评估患者的社会数据以及尖锐湿疣的典型特征。当患者不再前来进行评估治疗的会诊时，该患者即被视为失访。将失访患者的数据与其他患者的数据进行比较。
在研究期间纳入了297例病例，其中57%为男性。患者的平均年龄为33.8±11.4岁，43%的患者年龄在30岁以下。40%的病例中，病变已存在超过3个月，30%的病例有症状。在研究结束时，28.3%的患者被视为失访。通过多变量分析，失访似乎与患者年龄有关（患者越年轻，失访越频繁；p<0.04），而与治疗结束时确定确切的预约无关（p<0.001）。病变的无症状性质在单变量分析中被认为是失访危险因素，在多变量分析中处于显著意义的边缘（p = 0.06）。
临床医生在治疗尖锐湿疣的年轻无症状患者时应格外注意，努力降低失访率并提高管理质量。
