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外胚层发育不良患者的死亡、感染及体温过高风险:一项全国性研究

Risk of Death, Infections, and Hyperthermia in Ectodermal Dysplasias: A Nationwide Study.

作者信息

Herlin Laura Krogh, Schmidt Sigrún A J, Mogensen Trine H, Sommerlund Mette

机构信息

Department of Dermatology, Aarhus University Hospital, Aarhus Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Department of Dermatology, Aarhus University Hospital, Aarhus Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Acta Derm Venereol. 2025 Jun 18;105:adv43101. doi: 10.2340/actadv.v105.43101.

Abstract

This nationwide population-based study investigated the risk of death, infections, and hyperthermia in Danish patients with ectodermal dysplasia (ED). A validated cohort of ED patients (n = 396) and matched population comparators (n = 3960) was compared to assess these risks before (case-control analysis) and after ED diagnosis (cohort analysis). Using matched comparators as a reference, the overall hazard ratio (HR) for death was 1.33 (95% confidence interval [CI] 0.70-2.55) in ED patients, and particularly high in males with hypohidrosis (HR 3.77, 95% CI 1.57-9.03) and individuals diagnosed before age 18 (HR 6.53, 95% CI 1.84-23.13). ED was associated with an increased risk of hospital-diagnosed infections before (odds ratio [OR] 2.27, 95% CI 1.81-2.85) and after (HR 2.06, 95% CI 1.74-2.45) diagnosis, varying across subtypes. Sensitivity analyses supported these findings, e.g., using antimicrobial prescriptions to identify infections. An association between hypohidrosis and previous hyperthermia (OR 7.11, 95% CI 3.26-15.51) diminished after diagnosis (HR 1.38, 95% CI 0.54-3.53). This study found an increased mortality risk in males with hypohidrosis and those diagnosed in childhood, and infection and hyperthermia risks depending on ED subtype. These data enhance understanding of ED's clinical course, informing patient management and counselling.

摘要

这项基于全国人口的研究调查了丹麦外胚层发育不良(ED)患者的死亡、感染和体温过高风险。将经过验证的ED患者队列(n = 396)和匹配的人群对照者(n = 3960)进行比较,以评估这些风险在ED诊断之前(病例对照分析)和之后(队列分析)的情况。以匹配的对照者作为参考,ED患者的总体死亡风险比(HR)为1.33(95%置信区间[CI] 0.70 - 2.55),在有少汗症的男性患者(HR 3.77,95% CI 1.57 - 9.03)和18岁之前被诊断的个体中尤其高(HR 6.53,95% CI 1.84 - 23.13)。ED与诊断之前(优势比[OR] 2.27,95% CI 1.81 - 2.85)和之后(HR 2.06,95% CI 1.74 - 2.45)医院诊断的感染风险增加相关,不同亚型之间存在差异。敏感性分析支持了这些发现,例如使用抗菌药物处方来识别感染。少汗症与既往体温过高之间的关联(OR 7.11,95% CI 3.26 - 15.51)在诊断后有所减弱(HR 1.38,95% CI 0.54 - 3.53)。本研究发现,有少汗症的男性患者以及儿童期被诊断的患者死亡风险增加,且感染和体温过高风险取决于ED亚型。这些数据增进了对ED临床病程的理解,为患者管理和咨询提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d0e/12186435/b612347ed51d/ActaDV-105-43101-g001.jpg

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