2013 年至 2018 年住院瘢痕疙瘩病例的临床状况。
Clinical status of hospitalized keloid cases from 2013 to 2018.
机构信息
Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China.
Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Centre for Data Science in Health and Medicine, Peking University, Beijing, China.
出版信息
Burns. 2022 Dec;48(8):1874-1884. doi: 10.1016/j.burns.2021.12.007. Epub 2021 Dec 27.
OBJECTS
Keloids are intractable scar diseases and sometimes undergo hospitalization. This study aims to represent current status of keloid management in a national sample of hospitalized scar cases.
METHODS
Data of scar-diagnosed cases admitted in 1064 China's tertiary hospitals between 2013 and 2018, were obtained from the Hospital Quality Monitoring System (HQMS) database. Variables analyzed include sex, age, nationality, occupation, hospital department, accompanied symptoms at admission, surgical treatment, length of stay (LOS), and hospitalization cost. The potential risk factors of keloid diagnosis among scar cases were preliminarily identified through the Cochran-Mantel-Haenszel tests and univariate regression analyses.
RESULTS
This study identified 177,586 scar cases including 21,777 keloid cases and 155,809 non-keloid scar cases. The prevalence of scars in the HQMS database was gradually decreased from 0.123% in 2013 to 0.075% in 2018. We found a preponderances of males (54.32%), adults (61.52%), Han nationality (93.38%), and students (17.35%) in scar cases, among whom keloid cases accounted for growing proportions increasing from 9.2% in 2013 to 15.1% in 2018. Comparing non-keloid scar cases, keloid cases consisted of more women (59.1% VS 43.8%), office staffs (13.08% VS 6.75%) and retirees (5.16% VS 2.65%), and less Zhuang (0.79% VS 1.40%) and Hui nationalities (0.76% VS 1.00%), and showed lower incidence of accompanied symptoms (4.51% VS 47.96%) and higher rate of receiving operations (57.96% VS 50.28%, P < 0.001). Both the LOS and cost per hospitalization were lower in keloid cases. Furthermore, the adult and older women, Han and Uyghur nationalities, office staffs and retirees, and admitted in otolaryngology and dermatology departments, were potential predictors of keloid diagnosis among hospitalized scar cases.
CONCLUSION
When viewed at the national level, keloid occupies an important part in scar management in Chinese tertiary hospitals. Demographic and clinical differences between keloids and other scars facilitate understanding and promoting of individualized anti-scar therapeutic strategies.
目的
瘢痕疙瘩是一种难以治疗的瘢痕疾病，有时需要住院治疗。本研究旨在通过全国范围内住院瘢痕病例样本，阐述瘢痕疙瘩管理的现状。
方法
从医院质量监测系统（HQMS）数据库中获取了 2013 年至 2018 年期间在我国 1064 家三级医院住院的瘢痕诊断病例数据。分析的变量包括性别、年龄、国籍、职业、医院科室、入院时伴随症状、手术治疗、住院时间（LOS）和住院费用。通过 Cochran-Mantel-Haenszel 检验和单因素回归分析初步确定瘢痕病例中瘢痕疙瘩的潜在危险因素。
结果
本研究共纳入 177586 例瘢痕病例，其中瘢痕疙瘩 21777 例，非瘢痕疙瘩瘢痕 155809 例。HQMS 数据库中瘢痕的患病率逐渐从 2013 年的 0.123%下降到 2018 年的 0.075%。我们发现，瘢痕病例中男性（54.32%）、成年人（61.52%）、汉族（93.38%）和学生（17.35%）居多，其中瘢痕疙瘩的比例从 2013 年的 9.2%逐渐增加到 2018 年的 15.1%。与非瘢痕疙瘩瘢痕病例相比，瘢痕疙瘩病例中女性（59.1% VS 43.8%）、办公室工作人员（13.08% VS 6.75%）和退休人员（5.16% VS 2.65%）较多，壮族（0.79% VS 1.40%）和回族（0.76% VS 1.00%）较少，伴随症状发生率（4.51% VS 47.96%）较低，手术治疗率（57.96% VS 50.28%）较高（P<0.001）。瘢痕疙瘩病例的 LOS 和住院费用均较低。此外，成年和老年女性、汉族和维吾尔族、办公室工作人员和退休人员、耳鼻喉科和皮肤科就诊者是住院瘢痕病例中瘢痕疙瘩诊断的潜在预测因素。
结论
从全国范围来看，瘢痕疙瘩在我国三级医院的瘢痕管理中占有重要地位。瘢痕疙瘩与其他瘢痕之间的人口统计学和临床差异有助于理解和促进个体化抗瘢痕治疗策略。
Zotero 插件