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丙型肝炎病毒在住院精神病学中的监测:医生的实践。

Hepatitis C virus monitoring in inpatient psychiatry: Doctors' practice.

机构信息

Advanced Trainee in Old Age Psychiatry, 58416Western New South Wales Local Health District, NSW, Australia.

Associate Professor, 4334The University of SydneySchool of Rural Health, Orange, NSW, Australia.

出版信息

Australas Psychiatry. 2023 Feb;31(1):69-72. doi: 10.1177/10398562221133277. Epub 2022 Oct 14.

Abstract

OBJECTIVES

Current guidelines recommend routine Hepatitis C virus (HCV) monitoring in people with serious mental illness. We sought to determine the rates at which doctors practising in inpatient psychiatry units monitor the HCV exposure risk and HCV infection status of their patients.

METHODS

Electronic medical records (EMRs) of 50 short stay and 50 long stay mental health inpatients of a regional NSW hospital were retrospectively audited to determine the rates at which doctors screened for HCV and associated risk factors. Chi-squared analysis and Fisher's exact test were performed to compare the two groups.

RESULTS

Screening rates for HCV-associated risk factors varied according to the specific risk factor explored (prior incarceration 61%; intravenous drug use 55%; and tattoos/piercings 6%). Of 30 patients identified as having at least one HCV-associated risk factor, only 27% ( = 8) were tested for HCV during their admission, and the likelihood of testing was significantly higher in the long stay group. HCV infection status was documented for only one-third (34%) of patients.

CONCLUSIONS

There is significant scope for improvement in assessing HCV status and exposure risk in this setting. Improved awareness among mental health professionals as to the higher incidence of HCV in this population could elicit more widespread monitoring.

摘要

目的

目前的指南建议对患有严重精神疾病的人进行常规丙型肝炎病毒(HCV)监测。我们旨在确定在住院精神病学病房工作的医生监测其患者 HCV 暴露风险和 HCV 感染状况的比率。

方法

回顾性审核了新南威尔士州一家地区医院的 50 名短期住院和 50 名长期住院精神科住院患者的电子病历(EMR),以确定医生筛查 HCV 及相关危险因素的比率。采用卡方检验和 Fisher 确切检验对两组进行比较。

结果

根据所探讨的特定危险因素,HCV 相关危险因素的筛查率有所不同(既往监禁 61%;静脉吸毒 55%;纹身/穿孔 6%)。在确定至少存在一个 HCV 相关危险因素的 30 名患者中,只有 27%(=8)在住院期间接受了 HCV 检测,且长期住院组检测的可能性明显更高。仅记录了三分之一(34%)患者的 HCV 感染状况。

结论

在这种情况下,评估 HCV 状况和暴露风险仍有很大的改进空间。提高精神卫生专业人员对该人群中 HCV 发病率较高的认识,可能会促使更广泛的监测。

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