长期护理机构住院患者疥疮延迟诊断的危险因素。
Risk factors for delayed diagnosis of scabies in hospitalized patients from long-term care facilities.
作者信息
Lay Chorng-Jang, Wang Chun-Lung, Chuang Hui-Ying, Chen Ya-Lan, Chen Hsiang-Ling, Tsai Shu-Juan, Tsai Chen-Chi
机构信息
Division of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
出版信息
J Clin Med Res. 2011 Apr 4;3(2):72-7. doi: 10.4021/jocmr520w.
BACKGROUND
Delayed diagnosis of scabies can cause an institutional outbreak, which causes considerably economic burden to control. This study was to find the risk factors for delayed diagnosis of scabies in hospitalized patients from long-term care facilities.
METHODS
We conducted a retrospective analysis of the hospitalized patients from long-term care facilities, diagnosed to have scabies between January 2006 and December 2008. A stepwise logistic regression analysis was performed to determine the risk factors for delayed diagnosis of scabies.
RESULTS
A total of 706 episodes with scabies were identified retrospectively in 399 hospitalized patients from long-term care facilities. Of these, 44 episodes were considered as delayed diagnosis of scabies. These patients were more associated with chronic usage of steroid (73% vs. 10%, P < 0.001) and had longer duration of hospitalization than the others (30 vs. 13 days, P < 0.001). After logistic regression, steroid therapy was the risk factor of delayed diagnosis of scabies (odds ratio: 23.493).
CONCLUSIONS
In the patients from long-term care facilities, clinical physicians should pay more attention to those with chronic usage of steroid to avoid delayed diagnosis of scabies.
KEYWORDS
Scabies; Delayed diagnosis; Risk factor; Long-term care facility.
背景
疥疮的延迟诊断可导致机构内暴发，这会给控制工作带来相当大的经济负担。本研究旨在找出长期护理机构住院患者疥疮延迟诊断的危险因素。
方法
我们对2006年1月至2008年12月期间诊断为疥疮的长期护理机构住院患者进行了回顾性分析。进行逐步逻辑回归分析以确定疥疮延迟诊断的危险因素。
结果
从长期护理机构的399名住院患者中回顾性确定了总共706例疥疮发作。其中，44例被视为疥疮延迟诊断。这些患者与长期使用类固醇的关联更大（73%对10%，P<0.001），且住院时间比其他患者更长（30天对13天，P<0.001）。经过逻辑回归分析，类固醇治疗是疥疮延迟诊断的危险因素（比值比：23.493）。
结论
在长期护理机构的患者中，临床医生应更加关注长期使用类固醇的患者，以避免疥疮的延迟诊断。
关键词
疥疮；延迟诊断；危险因素；长期护理机构。
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