Mortality and morbidity associated with late diagnosis of anorectal malformations in children
Mortality and morbidity associated with late diagnosis of anorectal malformations in children
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DOI：
10.1016/s1479-666x(07)80083-7
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发表时间：
2007-12-01
影响因子：
2.5
通讯作者：
Fisher, R.
中科院分区：
文献类型：
--
作者：
Haider, N.;Fisher, R.
目的：本研究的目的是强调肛门直肠畸形的诊断时机和与任何延误相关的发病率和死亡率。方法：我们回顾性分析了1998年至2005年间在莱斯特儿童医院就诊的所有肛门直肠畸形患者。患者人口统计学资料包括诊断时的年龄、主诉、肛门直肠畸形类型和性别。仔细记录相关畸形以及诊断延迟导致的发病率和死亡率。结果：在52例患者中，28例（53%）的畸形诊断延迟。这种延迟与19%的显著发病率相关，不幸的是包括2例死亡（4%），均与漏诊直接相关。结论：尽管所有新生儿都进行了既定的、常规的、系统的出院前检查，但仍有相当比例的肛门直肠畸形在此时未被诊断。这一延误是发病率和死亡率居高不下的原因。简单的会阴检查可以清楚地发现所有肛门直肠畸形的存在，因此这种发病率和死亡率是完全可以避免的。
Aim: The aim of this study was to highlight the timing of diagnosis of anorectal malformations and the morbidity and mortality associated with any delay. Methods: We retrospectively reviewed all patients with anorectal malformations presenting to the Children's Hospital, Leicester between 1998-2005. Patient demographics included age at diagnosis, presenting complaint, type of anorectal malformation and sex. Associated malformations were carefully recorded as well as morbidity and mortality occurring as a consequence of the delay in diagnosis. Results: Out of a total of 52 patients, 28 (53%) had delay in diagnosis of the malformation. This delay was associated with significant morbidity in 19% and sadly included two deaths (4%), both being directly related to the missed diagnosis. Conclusion: Despite the established, routine, systematic pre-discharge examination in all neonates, a significant proportion of anorectal malformations are not diagnosed at this time. This delay is the cause of significant morbidity and mortality. Simple perineal examination will clearly identify the existence of all anorectal malformations and therefore such morbidity and mortality is totally avoidable.