Risk factors of return visit for hospitalization in children with hand-foot-mouth disease

( views:113, downloads:0 )
Author:
XU Can-li(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
HOU Zhi-wen(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
LI Yan(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
ZHANG Yon-hua(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
CHEN Hong(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
LI Chun-mei(Outpatient Department of Beijing Ditan Hospi-tal,Beijing 100011,China)
Journal Title:
CHINESE JOURNAL OF EMERGENCY MEDICINE
Issue:
Volume 17, Issue 12, 2008
DOI:
Key Word:
Hand-foot-mouth disease;Virus;Return to visist for hospitalization;Risk predict;Diagnostic evaluation

Abstract: Objective To investigate the risk factors in children with hand-foot-mouth disease(HFMD)hospitalized after the second visit to outpatient department(OPD),and to evaluate their predictive value.Method In May 2008,180 of 343 pediatric patients with HFMD were repatriated to family or community after preliminary diagnosis in Bering Ditan Hospital.The ill children hospitalized after revisit(RVH)were compared with the remaining children(control group)for seeking the differences in age,HFMD contagion,temperattLre,interval between onset and visit,WBC count,skin lesion and comphcating risk symptoms by respective analysis.Logistic regression analysis was performed to find the risk factors involved in patients with RVH and diagnostic evaluation was introducted to predict the probability of RVH.Results Of 180 ill children,17(9.44%)ones returned to family or community requested admission into hospital for further consultation because who symptoms urtremitted or complications developed.The average duration between the preliminary visit and second visit was 3.26 days(0.5~14 days).No significant differences were found between RVH group and control group in age(P=0.669),ratio of gender(P=0.101),conttagion with HFMD(P=0.104),and typing of vires(P=0.475).Compared with control groups,the significant prolongation of interval between onset and visist(3.71±1.10)d,significant eleva-tion of temperature(38.74±0.57)℃ and WBC counls(10.99±3.67)×109 were noticed in ill children of RVH(P<0.05).According to logistic regression,interval between onset and visit nlore than 3 days,body tem-perature at the first visit higher than 38.5℃,WBC count over 10.0×109,and the accompaniment of serious symptoms were confirmed to be independent risk factors involved in RVH.Of them,67.85%(11/16)ill children with three or more risk factors of RVH showed diagnosis sensitivity and specificity reach to 64.53%and 97.14%,respectively.Conclusions Risk factors confirmed are the interval between onset and the visist more than 3 days,bodv temperature higher than 38.5℃ at the first visit,WBC count more than 10.0×109,and the accompaniment of severe symptoms.The ill children with three or more risk factors are in great request of more closely monitoring and should not be the candidates for repatriation to family or community after preliminary diagnosis.

  • [1]朱汝南,钱渊,邓洁,等.北京市手足口病与肠道病毒71型和柯萨奇病毒A组16型感染有关[J].中华流行病学杂志,2007,28(10):1004-1008.
  • [2]Li L,He Y,Yang H,et al.Genetic characteristics of human enterovirus 71 and coxsackievirus A16 circulating from 1999 to 2004 in Shenzhen,People's Republic of China[J].J Clin Microbiol,2005,43(8):3835-3839.
  • [3]杨智宏,朱启镕,李秀珠,等.2002年上海儿童手足口病病例中肠道病毒71型和柯萨奇病毒A组16型的调查[J].中华儿科杂志,2005,43(9):648-652.
  • [4]料军保.张清友.进一步提高对莺症手足口病的认识[J].中华医学杂志,2007,87(33):2306.
  • [5]Shekhar K,Lye MS,Norlijah O,et al.Deaths in children during an otltbreak of hand,foot and mouth disease in Peninsular Malaysia-clinical and pashological characteristics[J].Ned J Malaysia,2005,60(3):297-304.
  • [6]Hamaguchi T,Fujisawa H,Sakai K,et al.Acute encephalitis caused by intrafamilial transmission of enterovirus 71 in.adult[J].Fanerg Infect Dis,2008,14(5):828-830.
  • [7]Shahmahmoodi S,Mehrabi Z,Eshraghian MR,et al.First detection of enterovirus 71 from an acute flaccid paralysis case with residual paralysis in Iran[J].J Clin Virol,2008,42(4):409-411.
  • [8]Yang TT,Huang LM,Lu CY.Clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern Taiwan,1994-2003[J].J Nicrobiol Immunol Infect,2005,38(6):417-424.
  • [9]石秀玉,孙若鹏.重症手足口病的治疗及预后[J].中国社区医师,2008,24(10):16.
  • [10]中华人民共和国卫生部.手足口病预防控制指南(2008版)[J].中国实用乡村医生杂志,2008,15(6):46-48.
  • [11]石秀玉,崔红,王纪文.手足口病的诊断与鉴别诊断[J].中国社区医师,2008,24(10):13.
  • [12]Chong CY,Chan KP,Shah VA,et al.Hand,foot and mouth disease in Singapore:a comparsion of fatal and nonfatal case[J].Acta Pediattics,2003,92(10):1163-1169.
  • [13]吴成翰,杨渤生,严晓华,等.高颅压脑膜脑炎的综合治疗分析[J].中华急诊医学杂志,2004,13(9):630-631.
  • [14]张庆荣,黄小卫,谭艳华,等.小儿急性肺水肿临床与病理分析[J].中华急诊医学杂志,2001,10(3):200-201.
  • [15]Lin NT,Wang JK,Lu FL,et al.Heart rate variability monitoring in the detection of central nervous system complications in children with enterovirus infection[J].J Crit Care,2006,21(3):280-286.
  • [16]Chen KT,Chang HL,Wang ST.Epidemiologic features of hang-footmouth disease and herpangina caused by enterovirus 71 in taiwan,1998-2005[J].Pediatrics,2007,120(2):244-252.
  • [17]蔡栩栩,刘春峰,邢艳玲,等.重症手足口病(附三例报告)[J].中国小儿急救医学,2006,13(6):556-558.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn