Dental infections increase the likelihood of hospital admissions among adult patients with sickle cell disease
Dental infections increase the likelihood of hospital admissions among adult patients with sickle cell disease
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DOI：
10.1922/cdh_3126laurence05
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发表时间：
2013-09-01
影响因子：
1.7
通讯作者：
Lanzkron, S.
中科院分区：
文献类型：
--
作者：
Laurence, B.;Haywood, C., Jr.;Lanzkron, S.
目的：确定牙科感染是否会增加成年镰状细胞病(SCD)患者入院的可能性。基础研究设计：对2006年至2008年全国急诊科样本(NEDS)的数据进行横断面分析。使用Poisson回归和稳健的方差估计来估计兴趣影响的患病率(PR)。参与者：18岁及以上的成年人，使用ICD-9-CM代码诊断为SCD，不包括使用镰状细胞特征代码出院的参与者。主要观察指标：急诊科就诊倾向，二分法表示急诊科就诊结束于入院还是接受治疗后出院。结果：在有镰状细胞危象的患者中，有牙科感染的患者比没有牙科感染的患者入院的可能性高72%(PR=1.72，95%CI 1.58-1.87)。没有观察到没有发生镰刀危象事件的成年SCD患者之间的关联。根据这项分析的初步数据，在SCD患者中预防牙齿感染每年估计可节省250万美元的成本。结论：在出现在急诊室的成年SCD患者中，牙齿感染合并镰状细胞危象显著增加了入院的可能性。
The objective: To determine if dental infections increase the likelihood of hospital admission among adult patients with sickle cell disease (SCD). Basic Research Design: Cross-sectional analysis of data from the Nationwide Emergency Department Sample (NEDS) pooled for the years 2006 through 2008. Prevalence ratios (PR) for the effects of interest were estimated using Poisson regression with robust estimates of the variance. Participants: Adults, aged 18 and over, diagnosed with SCD using ICD-9-CM codes excluding participants discharged with a code for sickle cell trait. Main outcome measure: Emergency department (ED) visit disposition, dichotomised to represent whether or not the ED visit ended in admission versus being treated and released. Results: Among patients having a sickle cell crisis, those with dental infections were 72% more likely to be admitted compared to those not having dental infections (PR=1.72, 95% CI 1.58-1.87). No association was observed among adult SCD patients not having a sickle crisis event. Based on preliminary data from this analysis, prevention of dental infection among patients with SCD could result in an estimated cost saving of $ 2.5 million dollars per year. Conclusions: Having a dental infection complicated by a sickle cell crisis significantly increases the likelihood of hospital admission among adult SCD patients presenting to the ED.