Nicolaï D, Farcet A, Molines C, Delalande G, Retornaz F
Pôle de gériatrie polyvalente, centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France.
Pôle de gériatrie polyvalente, centre gérontologique départemental, 176, avenue de Montolivet, 13012 Marseille, France; EA3279, évaluation des systèmes de soins - santé perçue, université de la Méditerranée, 13006 Marseille, France; Département de médecine interne et maladies infectieuses, hôpital Européen, rue Désirée-Clary, 13001 Marseille, France.
Rev Med Interne. 2015 May;36(5):307-11. doi: 10.1016/j.revmed.2014.10.001. Epub 2014 Nov 8.
Tetanus is a serious disease, which could be potentially lethal. All cases are observed in patients inadequately immunized. The immunochromatographic tests (including Tetanos quick Stick(®) [TQS]) have demonstrated their efficiency in emergency setting. The aim of our study was to assess the usefulness of these tests in elderly outpatients seen in ambulatory settings.
This prospective study included patients aged 65 years and over who presented to the outpatients' clinic of the Gerontologic Departmental Center (Marseille). A TQS and a self-administered questionnaire to assess risk factors for tetanus were performed.
One hundred and twenty-two patients were studied. The prevalence of positive TQS was 66%. Patients have an average of 2.5 risk factors for tetanus. Negative TQS was observed in 35% of patients who had seen their general practitioner for a wound during the previous year.
Elderly patients accumulate several risk factors regardless of age and lifestyle. While physicians are familiar with the vaccine recommendations, they are often faced with the difficulty of assessing patient's status based only on the patient's interview, which is frequently not reliable. The implementation of immunochromatographic tests in general practice could help physicians in the management of patients at risk for tetanus.
破伤风是一种严重疾病，可能会危及生命。所有病例均见于免疫接种不足的患者。免疫层析检测（包括破伤风快速检测棒 [TQS]）已证明其在紧急情况下的有效性。我们研究的目的是评估这些检测在门诊老年患者中的实用性。
这项前瞻性研究纳入了65岁及以上到老年病科中心（马赛）门诊就诊的患者。进行了一次TQS检测以及一份用于评估破伤风危险因素的自填式问卷。
共研究了122例患者。TQS检测呈阳性的患病率为66%。患者破伤风危险因素平均有2.5个。在上一年因伤口看过全科医生的患者中，35%的患者TQS检测呈阴性。
老年患者无论年龄和生活方式如何都会累积多种危险因素。虽然医生熟悉疫苗接种建议，但他们常常面临仅通过患者访谈来评估患者状况的困难，而这种访谈往往不可靠。在全科医疗中开展免疫层析检测有助于医生管理破伤风风险患者。
