Havens P L, Butler J C, Day S E, Mohr B A, Davis J P, Chusid M J
Department of Pediatrics, Medical College of Wisconsin, Milwaukee.
Am J Public Health. 1993 Mar;83(3):379-84. doi: 10.2105/ajph.83.3.379.
A large number of children with measles were hospitalized at a children's hospital during a metropolitan measles outbreak. In this study we addressed the appropriateness of those admissions.
Charts of all 634 patients with a diagnosis of measles who were treated between August 1989 and April 1990 were reviewed. Determination of the appropriateness of hospital admission was based on severity of illness and presence of severe complications of measles.
Of 564 patients with clinical measles or serologic evidence of recent infection, 252 were inpatients (median age 1.5 years) and 312 were outpatients (median age 2.1 years). Fifty-nine (23.4%) of the inpatients had been inappropriately admitted. Inpatients were significantly more likely than outpatients to have physiologic instability or a clinical complication. Children 15 months of age or younger were more likely to be hospitalized, as were children evaluated in the first 3 months of the outbreak period, even if admission was not appropriate on the basis of physiologic instability or complications.
Younger patients with measles and patients evaluated earlier in the epidemic were more likely to be admitted to the hospital even when admission was inappropriate as assessed by degree of physiologic instability or presence of complications.
在一次大城市麻疹暴发期间，大量患麻疹的儿童在一家儿童医院住院。在本研究中，我们探讨了这些住院病例的合理性。
回顾了1989年8月至1990年4月期间接受治疗的所有634例诊断为麻疹的患者的病历。根据疾病严重程度和麻疹严重并发症的存在来确定住院的合理性。
在564例有临床麻疹或近期感染血清学证据的患者中，252例为住院患者（中位年龄1.5岁），312例为门诊患者（中位年龄2.1岁）。59例（23.4%）住院患者入院不当。住院患者比门诊患者更有可能出现生理不稳定或临床并发症。15个月龄及以下的儿童更有可能住院，在暴发期的前3个月接受评估的儿童也是如此，即使根据生理不稳定或并发症情况入院并不合适。
患麻疹的年幼患者以及在疫情早期接受评估的患者更有可能住院，即使根据生理不稳定程度或并发症情况评估入院并不合适。
