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全年呼吸诊断:揭开儿科感染周期的多面性。

Respiratory Diagnoses Year-Round: Unraveling the Multifaceted Pediatric Infection Cycles.

机构信息

Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland.

Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland.

出版信息

Influenza Other Respir Viruses. 2024 Nov;18(11):e70037. doi: 10.1111/irv.70037.

Abstract

OBJECTIVE

The aim of the study is to analyze the annual cycle of pediatric medically attended respiratory illnesses.

STUDY DESIGN

Data on 141 million pediatric respiratory visits from the years 2010-2019 were obtained from the Polish National Healthcare Fund. To identify underlying patterns and trends within the aggregated data, techniques like seasonal-trend decomposition using LOESS (STL) and principal component analysis (PCA) were applied.

RESULTS

A strongly recurring pattern was observed. Following the annual minimum in late summer, there was a sudden surge in upper respiratory infections in early September. Subsequently, overall visits declined gradually, while the share of lower respiratory infections increased, particularly during the influenza peaks from January to March. Afterwards, visits declined steadily, with an additional peak of tonsillopharyngitis noted in midsummer. Dimensionality reduction of diagnoses implied the existence of two major groups of co-occurring diagnoses, the proportions of which change over the year: one smaller but more severe, peaking during the influenza season, and the second dominating with lower severity. Age differences in diagnoses were observed, with babies showing upper respiratory infections likely diagnosed with the common cold rather than a more specific upper respiratory infection.

CONCLUSION

While enhancing surveillance strategies is indeed a desirable long-term goal, it is worth noting that despite the variability observed in the onset of the influenza season, the infection cycles generally follow a relatively fixed pattern. This consistency provides a foundation for effective planning and underscores the potential for proactive measures to mitigate the impact of seasonal outbreaks.

摘要

目的

本研究旨在分析儿科有医疗记录的呼吸道疾病的年度周期。

研究设计

从 2010 年至 2019 年,从波兰国家医疗保健基金获得了 1.41 亿例儿科呼吸道就诊的数据。为了识别聚合数据中的潜在模式和趋势,使用局部估计散点平滑法(LOESS)季节性趋势分解(STL)和主成分分析(PCA)等技术。

结果

观察到一个强烈的重复模式。在夏末的年度最小值之后,9 月初上呼吸道感染突然激增。随后,就诊次数逐渐下降,而下呼吸道感染的比例增加,特别是在 1 月至 3 月的流感高峰期。之后,就诊次数稳步下降,夏季中旬注意到扁桃体咽炎的额外高峰。诊断的降维意味着存在两个主要的共同发生诊断组,其比例随时间变化:一个较小但更严重,在流感季节达到高峰,另一个主要的严重程度较低。诊断中的年龄差异明显,婴儿表现出上呼吸道感染,可能被诊断为普通感冒而不是更具体的上呼吸道感染。

结论

虽然加强监测策略确实是一个理想的长期目标,但值得注意的是,尽管流感季节的开始存在可变性,但感染周期通常遵循相对固定的模式。这种一致性为有效规划提供了基础,并强调了采取主动措施减轻季节性爆发影响的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e7/11534662/22439ae9ddef/IRV-18-e70037-g003.jpg

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