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牙齿感染会增加成年镰状细胞病患者住院的可能性。

Dental infections increase the likelihood of hospital admissions among adult patients with sickle cell disease.

作者信息

Laurence B, Haywood C, Lanzkron S

机构信息

Howard University College of Dentistry, Washington, DC 20059, USA.

出版信息

Community Dent Health. 2013 Sep;30(3):168-72.

Abstract

THE OBJECTIVE

To determine if dental infections increase the likelihood of hospital admission among adult patients with sickle cell disease (SCD).

BASIC RESEARCH DESIGN

Cross-sectional analysis of data from the Nationwide Emergency Department Sample (NEDS) pooled for the years 2006 through 2008. Prevalence ratios (PR) for the effects of interest were estimated using Poisson regression with robust estimates of the variance.

PARTICIPANTS

Adults, aged 18 and over, diagnosed with SCD using ICD-9-CM codes excluding participants discharged with a code for sickle cell trait.

MAIN OUTCOME MEASURE

Emergency department (ED) visit disposition, dichotomised to represent whether or not the ED visit ended in admission versus being treated and released.

RESULTS

Among patients having a sickle cell crisis, those with dental infections were 72% more likely to be admitted compared to those not having dental infections (PR = 1.72, 95% CI 1.58-1.87). No association was observed among adult SCD patients not having a sickle crisis event. Based on preliminary data from this analysis, prevention of dental infection among patients with SCD could result in an estimated cost saving of $2.5 million dollars per year.

CONCLUSIONS

Having a dental infection complicated by a sickle cell crisis significantly increases the likelihood of hospital admission among adult SCD patients presenting to the ED.

摘要

目的

确定牙齿感染是否会增加成年镰状细胞病(SCD)患者住院的可能性。

基础研究设计

对2006年至2008年全国急诊科样本(NEDS)汇总数据进行横断面分析。使用具有稳健方差估计的泊松回归估计感兴趣效应的患病率比(PR)。

参与者

年龄在18岁及以上的成年人,使用ICD-9-CM编码诊断为SCD,排除出院时编码为镰状细胞性状的参与者。

主要结局指标

急诊科(ED)就诊处置情况,分为就诊结局是住院还是接受治疗并出院。

结果

在患有镰状细胞危象的患者中,有牙齿感染的患者比没有牙齿感染的患者住院可能性高72%(PR = 1.72,95%CI为1.58 - 1.87)。在没有镰状细胞危象事件的成年SCD患者中未观察到相关性。根据该分析的初步数据,预防SCD患者的牙齿感染估计每年可节省250万美元。

结论

患有牙齿感染并伴有镰状细胞危象会显著增加成年SCD患者到急诊科就诊时住院的可能性。

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