一项回顾性研究，旨在评估三级医疗环境中住院皮肤科会诊对诊断准确性的影响。

A Retrospective Study to Evaluate the Impact of In-Patient Dermatological Consultations on Diagnostic Accuracy in a Tertiary Care Setting.

作者信息

Vinay Keshavamurthy, Thakur Vishal, Choudhary Rajat, Dev Anubha, Chatterjee Debajyoti, Handa Sanjeev

机构信息

Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian Dermatol Online J. 2021 May 12;12(3):417-422. doi: 10.4103/idoj.IDOJ_555_20. eCollection 2021 May-Jun.

DOI:10.4103/idoj.IDOJ_555_20

PMID:34211908

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8202492/

Abstract

BACKGROUND

Dermatology is primarily an outpatient specialty. However, dermatology consultations play an important role in care of inpatients. Data on inpatient dermatological consultations in tertiary care settings is limited.

OBJECTIVES

To evaluate clinical characteristics of inpatient dermatological consultations and effect on clinical outcomes in a tertiary care setting.

METHODS

This was a single-center retrospective study where the records of all dermatological consultations for patients admitted under various specialties, emergency services, and intensive care units (ICU) at our tertiary care institute over 2 years period were reviewed. The details of patients, primary care unit, dermatological complaints, diagnosis, investigations performed, treatment given, and follow-up were recorded and analyzed.

RESULTS

Total of 1717 dermatologic consultations (1000 males) were recorded, with mean age of study population being 33.6 ± 21.6 years (median - 32 years). Out of total 1717 patients, 136 (7.9%), 321 (18.7%), 1135 (66.1%), and 125 (7.3%) patients were infants, children, adolescents, adults, and elderly, respectively. The most frequent diagnostic group was infective diseases (586; 34.1%) followed by inflammatory diseases (442; 25.7%), mucocutaneous adverse drug reactions (160; 9.3%), and autoimmune diseases (65; 3.8%). Primary team's diagnosis was concordant with the dermatology consultation in 1112 (64.8%) patients and discordant observations were recorded in 605 patients (35.2%). Most discordant dermatological diagnoses included inflammatory disorders such as lichen planus, atopic dermatitis, bullous pemphigoid; mechanical disorders; nutritional deficiency disorders, and benign neoplasms.

CONCLUSION

Common skin conditions account for a large majority of dermatologic consultations in a hospital setting. Inpatient dermatology consultations improve the diagnostic accuracy.

摘要

背景

皮肤科主要是门诊专科。然而，皮肤科会诊在住院患者护理中发挥着重要作用。三级医疗环境中住院皮肤科会诊的数据有限。

目的

评估三级医疗环境中住院皮肤科会诊的临床特征及其对临床结局的影响。

方法

这是一项单中心回顾性研究，回顾了我们三级医疗机构在2年期间内各专科、急诊服务和重症监护病房（ICU）收治患者的所有皮肤科会诊记录。记录并分析了患者的详细信息、初级护理单元、皮肤问题、诊断、进行的检查、给予的治疗以及随访情况。

结果

共记录了1717例皮肤科会诊（男性1000例），研究人群的平均年龄为33.6±21.6岁（中位数-32岁）。在总共1717例患者中，婴儿、儿童、青少年、成年人和老年人分别为136例（7.9%）、321例（18.7%）、1135例（66.1%）和125例（7.3%）。最常见的诊断类别是感染性疾病（586例；34.1%），其次是炎症性疾病（442例；25.7%）、皮肤黏膜药物不良反应（160例；9.3%）和自身免疫性疾病（65例；3.8%）。初级团队的诊断与皮肤科会诊结果在1112例（64.8%）患者中一致，605例（35.2%）患者记录有不一致的观察结果。最不一致的皮肤科诊断包括扁平苔藓、特应性皮炎、大疱性类天疱疮等炎症性疾病；机械性疾病；营养缺乏性疾病和良性肿瘤。