Skyum Florence, Abed Osama Karim, Mogensen Christian Backer
Kresten Philipsensvej 15, 6200 Aabenraa, Denmark.
Dan Med J. 2014 Jun;61(6):A4850.
The number of admissions for acute gastroenteritis (GE) is increasing. The majority of patients pass through a single high-flow emergency department (ED) area which increases the risk of spreading GE. The aim of this study was to determine the frequency and aetiology of GE for acutely admitted patients and to analyse their clinical information focusing on risk indicators of contagious aetiology and on the chosen isolation regime to determine if the GE required a contact precaution isolation regime.
This study included patients above 16 years of age who were admitted acutely within a one-year study period to a Danish hospital with a catchment population of 231,000 persons. The following items were analysed: information from the referring doctor, diarrhoea, nausea and vomiting and fever history, abdominal pain, prior antibiotics, co-morbidity, drugs, travel history, contagious contacts, general condition, vital values, isolation regime, final diagnosis and results of stool examination.
Among 17,531 acute admissions, 1.6% had acute GE and 60% of these had stool examinations performed. Only 35% of the patients with GE had information about possible GE at referral. Short duration and vomiting may help to identify norovirus and antibiotic treatment within the last month to identify Clostridium difficile infections. All patients with highly infective GE were isolated under a contact precaution regime, but only one in four of the isolated patients were actually highly contagious.
Acute GE is a prevalent condition in the ED; a number of patients are isolated unnecessarily, but it is difficult to assess correctly who should be isolated and who should not. We recommend that further studies be undertaken to define isolation criteria and to assess the usefulness of new rapid analysis modalities with a view to reducing the isolation period.
not relevant.
not relevant.
急性肠胃炎（GE）的入院人数正在增加。大多数患者在单一的高流量急诊科区域就诊，这增加了GE传播的风险。本研究的目的是确定急性入院患者中GE的发病率和病因，并分析他们的临床信息，重点关注传染性病因的风险指标以及所选的隔离措施，以确定GE是否需要接触预防隔离措施。
本研究纳入了在为期一年的研究期间急性入院至一家丹麦医院的16岁以上患者，该医院的服务人口为23.1万人。分析了以下项目：转诊医生提供的信息、腹泻、恶心和呕吐以及发热病史、腹痛、既往抗生素使用情况、合并症、药物、旅行史、有传染性的接触者、一般状况、生命体征、隔离措施、最终诊断和粪便检查结果。
在17531例急性入院患者中，1.6%患有急性GE，其中60%进行了粪便检查。只有35%的GE患者在转诊时有关于可能患GE的信息。病程短和呕吐可能有助于识别诺如病毒，而过去一个月内使用抗生素治疗有助于识别艰难梭菌感染。所有具有高度传染性的GE患者均按照接触预防措施进行隔离，但实际上只有四分之一的隔离患者具有高度传染性。
急性GE在急诊科是一种常见疾病；许多患者被不必要地隔离，但很难正确评估谁应该被隔离以及谁不应该被隔离。我们建议进行进一步研究以确定隔离标准，并评估新的快速分析方法的有效性，以期缩短隔离期。
不相关。
不相关。
