Brown R, Bancewicz J, Hamid J, Tillotson G, Ward C, Irving M
Ann Surg. 1982 Dec;196(6):672-6. doi: 10.1097/00000658-198212001-00010.
Delayed hypersensitivity skin testing was performed at weekly intervals on 95 patients with major surgical illness. Patients with abnormal reactions on initial skin testing had a higher mortality than those who were normal initially (p less than 0.01), but this was not due to a greater rate of major septic complications. Significantly higher rates of sepsis (p less than 0.001) and mortality (p less than 0.001) were found in patients with abnormal reactions at any stage of their illness compared with patients who remained normal throughout. However, careful study of the temporal relationship between skin reactions and clinical events in individual patients suggested that these differences were not of value in clinical practice. Abnormal reactions usually followed obvious complications, such as sepsis or secondary hemorrhage, rather than predicted them. Deterioration of skin reactions from normal to abnormal was observed on 32 occasions in 25 patients but preceded the development of sepsis in only four patients.
对95例患有重大外科疾病的患者每隔一周进行迟发型超敏反应皮肤试验。初始皮肤试验反应异常的患者死亡率高于初始反应正常的患者（p<0.01），但这并非由于严重脓毒症并发症发生率更高。与整个病程中反应一直正常的患者相比，在疾病任何阶段反应异常的患者脓毒症发生率（p<0.001）和死亡率（p<0.001）显著更高。然而，对个体患者皮肤反应与临床事件之间时间关系的仔细研究表明，这些差异在临床实践中并无价值。异常反应通常出现在明显并发症如脓毒症或继发性出血之后，而非在其之前。在25例患者中观察到32次皮肤反应从正常变为异常的情况，但只有4例在脓毒症发生之前出现这种变化。
