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

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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:
Volume 17, Issue 12, 2008
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.

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