Oliver Jane, Robertson Oliver, Zhang Jane, Marsters Brooke L, Sika-Paotonu Dianne, Jack Susan, Bennett Julie, Williamson Deborah A, Wilson Nigel, Pierse Nevil, Baker Michael G
Emerg Infect Dis. 2021 Jul;27(7):1893-902. doi: 10.3201/eid2707.203045.
We investigated outcomes for patients born after 1983 and hospitalized with initial acute rheumatic fever (ARF) in New Zealand during 1989-2012. We linked ARF progression outcome data (recurrent hospitalization for ARF, hospitalization for rheumatic heart disease [RHD], and death from circulatory causes) for 1989-2015. Retrospective analysis identified initial RHD patients <40 years of age who were hospitalized during 2010-2015 and previously hospitalized for ARF. Most (86.4%) of the 2,182 initial ARF patients did not experience disease progression by the end of 2015. Progression probability after 26.8 years of theoretical follow-up was 24.0%; probability of death, 1.0%. Progression was more rapid and ≈2 times more likely for indigenous Māori or Pacific Islander patients. Of 435 initial RHD patients, 82.2% had not been previously hospitalized for ARF. This young cohort demonstrated low mortality rates but considerable illness, especially among underserved populations. A national patient register could help monitor, prevent, and reduce ARF progression.
我们调查了1983年后出生、于1989年至2012年期间在新西兰因首次急性风湿热（ARF）住院的患者的预后情况。我们将1989年至2015年期间ARF进展的预后数据（ARF再次住院、风湿性心脏病[RHD]住院以及循环系统疾病导致的死亡）进行了关联。回顾性分析确定了2010年至2015年期间住院且之前因ARF住院的40岁以下的初发RHD患者。在2182例初发ARF患者中，大多数（86.4%）在2015年底前未出现疾病进展。经过26.8年的理论随访，进展概率为24.0%；死亡概率为1.0%。对于原住民毛利人或太平洋岛民患者，疾病进展更快，可能性约为其他患者的2倍。在435例初发RHD患者中，82.2%之前未曾因ARF住院。这一年轻队列显示出低死亡率，但疾病负担较重，尤其是在服务不足的人群中。全国患者登记册有助于监测、预防和减少ARF的进展。
