Risk factors of admission in school children with severe atopic dermatitis
Risk factors of admission in school children with severe atopic dermatitis
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重度特应性皮炎学童入学的危险因素
DOI：
10.1111/1346-8138.16612
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Ohya Yukihiro
中科院分区：
文献类型：
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作者：
Miyaji Yumiko;Yamamoto‐Hanada Kiwako;Fukuie Tatsuki;Narita Masami;Ohya Yukihiro
目前尚无关于学龄儿童使用局部皮质类固醇（TCS）进行积极治疗的入院风险因素和长期（>1年）预后的数据。本研究旨在确定因异位性皮炎（AD）住院后接受积极治疗3年以上的学龄儿童的预后。这项回顾性队列研究使用了2008年1月至2013年12月在国家儿童健康与发展中心接受AD长期住院治疗的学龄儿童（5-19岁）的电子病历数据。从他们的医疗记录中回顾性地确定了出院后1年和3年的长期预后。最常见的加重因素是依从性差（51.8%）。在住院后1年和3年，分别有87.3%和74.3%的儿童在躯干和四肢上使用TCS少于每周两次。出院后1年和3年时，研究者对AD评分的总体评估分别为81.0%和75.7%。随访期间AD控制良好。11.8%的儿童因AD再次住院。依从性差是入院的最大风险因素。患有重度AD的儿童可以通过长期的入院AD计划和出院后3年使用TCS的家庭主动治疗获得良好的AD控制。保持AD治疗的良好依从性是防止病情加重和改善学龄儿童未来预后的必要条件。然而，我们需要为需要再次住院的儿童提供帮助。
There are no data about risk factor of admission and long‐term (>1 year) prognosis of proactive therapy using topical corticosteroids (TCSs) in school children. This study aims to identify the prognosis of school children over 3 years treated with proactive therapy after hospitalization due to atopic dermatitis (AD). This retrospective cohort study used electronic medical record data of schoolchildren (aged 5–19 years) with a long‐term admission program for AD at the National Center for Child Health and Development from January 2008 to December 2013. Long‐term prognosis at 1 and 3 years after discharge were retrospectively identified from their medical records. The most common exacerbation factor was poor adherence (51.8%). At 1 and 3 years after hospitalization, 87.3% and 74.3%, respectively, of the children used TCSs on their trunk and limbs less than twice a week. Investigator's Global Assessment of AD scores were ≤1 for 81.0%and 75.7% at 1 and 3 years after discharge, respectively. AD was well‐controlled during follow‐up. Rehospitalization due to AD was observed in 11.8% children. Poor adherence was biggest risk factor for admission. Children with severe AD could achieve well‐controlled AD with a long‐term admission AD program and home‐based proactive therapy using TCSs for 3 years after discharge. Maintaining good adherence for AD treatment is required to prevent exacerbation and improve future prognosis in school children. However, we need to engage for the children who required rehospitalization.