Jero J, Virolainen A, Virtanen M, Eskola J, Karma P
Department of Otolaryngology, Helsinki University Central Hospital, Finland.
Acta Otolaryngol. 1997 Mar;117(2):278-83. doi: 10.3109/00016489709117787.
Factors associated with poor outcome of acute otitis media (AOM) were analysed in 131 children aged 1/4 to 7 1/2 (median 2 1/2) years. After AOM, altogether 37 (28%) of the children had poor outcome: 15 children (12%) clinical failure (unimprovement or worsening of pre-treatment signs and symptoms within 2 weeks of onset of therapy) and 31 (24%) persistent middle ear effusion (MEE) > or = 1 month post-treatment. Of the different variables studied in multivariate analysis, age < 2 years (p < 0.01), history of allergic skin or respiratory symptoms (p = 0.02), > or = 6 h duration of pre-treatment earache (p = 0.01) and B. catarrhalis in MEE (p = 0.05) were associated with clinical failure. Children with previous adenotomy or unilateral AOM had no failures. Persistence of MEE at 1 month was associated with age < 2 years (p = 0.05), otitis proneness (p = 0.03), bilaterality of AOM (p < 0.01) and S. pneumoniae in MEE (p = 0.01) in univariate but not in multivariate analysis.
对131名年龄在1/4至7岁半（中位数为2岁半）的儿童进行了急性中耳炎（AOM）预后不良相关因素的分析。AOM发作后，共有37名（28%）儿童预后不良：15名儿童（12%）临床治疗失败（治疗开始后2周内，治疗前的体征和症状未改善或加重），31名（24%）治疗后持续性中耳积液（MEE）≥1个月。在多变量分析中研究的不同变量中，年龄＜2岁（p＜0.01）、有过敏性皮肤或呼吸道症状史（p = 0.02）、治疗前耳痛持续时间≥6小时（p = 0.01）以及MEE中存在卡他莫拉菌（p = 0.05）与临床治疗失败相关。既往接受过腺样体切除术或单侧AOM的儿童没有治疗失败的情况。在单变量分析中，1个月时MEE持续存在与年龄＜2岁（p = 0.05）、易患中耳炎（p = 0.03）、AOM双侧发病（p＜0.01）以及MEE中存在肺炎链球菌（p = 0.01）相关，但在多变量分析中无相关性。
