Todd J K, Wiesenthal A M, Ressman M, Caston S A, Hopkins R S
Am J Epidemiol. 1985 Nov;122(5):857-67. doi: 10.1093/oxfordjournals.aje.a114168.
Medical records for hospitalized patients between 30 days and 30 years of age at two hospitals, one in each of two Colorado counties, were reviewed for possible cases of toxic shock syndrome conforming to one or both of two clinical case definitions. Patients with toxic shock syndrome were detected in each year from 1970 through 1982. Fifty patients with possible toxic shock syndrome were identified; 14 were males, five were premenarchal females, and the remaining 31 were females of menstrual age of whom 21 (42% overall) were menstruating at the time of illness. The combined annual toxic shock syndrome incidence rate ranged between 0.8/100,000 population less than or equal to 30 years of age (1974) and 9.1/100,000 (1980) with a maximum of 15.8/100,000 (1980) in females between the ages of 10 and 30. Incidence curves for males, females less than or equal to 30 years of age, and females of menstrual age (10-30 years) fluctuated in a statistically (p less than 0.02) nonrandom fashion, each peaking in 1979-1980 and declining in 1981. In a separate statewide voluntary case reporting system, 103 cases of toxic shock syndrome of all ages were reported by health care providers with onset from 1970-1982. A minimum estimate of 26 (26%) of these were not menstrually-associated, occurring in five females prior to menarche, three following menopause, three postpartum, and 15 males. Total cases reached an annual peak in 1980, declined somewhat in 1981, and increased during 1982 to levels comparable to 1980. Less than half (46%) of the strictly defined cases actively ascertained in the retrospective hospitalized population study had been reported voluntarily to the statewide system. Jurisdictions depending primarily on passive toxic shock syndrome case ascertainment techniques, even with periodic active solicitations, may not be reliably detecting the majority of cases, and those cases which are so reported may be limited by physician perception of syndrome spectrum.
对科罗拉多州两个县各一家医院30天至30岁住院患者的病历进行了审查，以查找符合两种临床病例定义之一或两者的中毒性休克综合征可能病例。1970年至1982年每年均检测到中毒性休克综合征患者。共识别出50例可能的中毒性休克综合征患者；其中14例为男性，5例为初潮前女性，其余31例为育龄女性，其中21例（占总数的42%）在发病时处于月经期。年龄小于或等于30岁人群的中毒性休克综合征综合年发病率在0.8/10万（1974年）至9.1/10万（1980年）之间，10至30岁女性的发病率最高达15.8/10万（1980年）。男性、年龄小于或等于30岁的女性以及育龄女性（10 - 30岁）的发病率曲线呈统计学上（p < 0.02）的非随机波动，均在1979 - 1980年达到峰值，并于1981年下降。在一个单独的全州自愿病例报告系统中，医疗保健人员报告了1970 - 1982年发病的所有年龄段的103例中毒性休克综合征病例。据最低估计，其中26例（26%）与月经无关，发生在5例初潮前女性、3例绝经后女性、3例产后女性以及15例男性中。病例总数在1980年达到年度峰值，1981年有所下降，1982年又升至与1980年相当的水平。在回顾性住院患者研究中主动确定的严格定义病例中，不到一半（46%）已自愿报告给全州系统。主要依靠被动中毒性休克综合征病例确定技术的辖区，即使定期进行主动征集，可能也无法可靠地检测到大多数病例，而且那些报告的病例可能受到医生对综合征范围认知的限制。
