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分析影响小儿急性乳突炎预后的因素。

Analysis of Prognostic Factors Impacting Pediatric Acute Mastoiditis Outcomes.

机构信息

Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.

Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice School of Medicine, University of Zagreb, Croatia.

出版信息

J Int Adv Otol. 2023 Jan;19(1):50-54. doi: 10.5152/iao.2023.22794.

Abstract

BACKGROUND

This study aimed to investigate the outcomes of pediatric patients with acute mastoiditis while examining the role of intravenous steroid therapy, patient demographics, and serum inflammatory values as prognostic factors.

METHODS

This study is a single-center retrospective observational study including 73 consecutive patients treated for acute mastoiditis in the course of the 10-year study period (January 2010 to December 2019).

RESULTS

Data analysis showed that patients requiring surgical treatment (14%) had a 3-fold higher C-reactive protein value at admission compared to those treated conservatively (P < .001). Receiver operating characteristic analysis revealed that a C-reactive protein cut-off of ≥98.7 had a sensitivity and specificity of 100% and 74.6%, respectively, for predicting the need for surgery (area under the curve=0.927, P < .001). The duration of symptoms before hospitalization was nearly 2 days shorter in male patients (P=.031), and the use of intravenous steroid therapy significantly shortened the length of hospitalization (P=.023), by 1.4 days on average.

CONCLUSION

Intravenous steroid therapy may be useful in decreasing the length of hospital stay. Mastoiditis tends to present more severely in male patients, and monitoring C-reactive protein values during treatment correlated well with the need for surgery.

摘要

背景

本研究旨在探讨小儿急性乳突炎的治疗结果,同时研究静脉类固醇治疗、患者人口统计学特征和血清炎症值作为预后因素的作用。

方法

本研究为单中心回顾性观察性研究,纳入了在 10 年研究期间(2010 年 1 月至 2019 年 12 月)接受急性乳突炎治疗的 73 例连续患者。

结果

数据分析显示,需要手术治疗的患者(14%)入院时 C 反应蛋白值比保守治疗患者高 3 倍(P <.001)。受试者工作特征分析显示,C 反应蛋白临界值≥98.7 预测手术需要的敏感性和特异性分别为 100%和 74.6%(曲线下面积为 0.927,P <.001)。男性患者的症状前住院时间平均缩短近 2 天(P=.031),静脉类固醇治疗显著缩短了住院时间(P=.023),平均缩短 1.4 天。

结论

静脉类固醇治疗可能有助于缩短住院时间。男性患者的乳突炎往往表现更为严重,治疗过程中监测 C 反应蛋白值与手术需要密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b89/9984910/dafd14984e8e/jiao-19-1-50_f001.jpg

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