瑞典儿童急性乳突炎的复杂性

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-04-08 DOI:10.1016/j.ijporl.2025.112346

Julia Arebro , Rutger Bennet , Margareta Eriksson , Anna Granath

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引用次数: 0

摘要

目的：急性乳突炎（AM）是儿童急性中耳炎（AOM）的罕见并发症。基于人群的研究有助于制定适当的治疗策略，并评估2007年引入肺炎球菌结合疫苗（PCV）的相关效果。然而，先前的报告报告了AM的过度诊断，保证了有效性评估的必要性。本研究的目的是评估ICD-10诊断AM的有效性，并解决鉴别诊断。此外，我们的目标是绘制AM随时间的发病率图，并具体绘制延迟恢复的病例图。方法回顾性分析瑞典斯德哥尔摩地区2003年至2019年诊断为乳突炎的所有住院儿科病例。手动审查病例记录以验证AM的诊断并图表收集数据。结果在ICD-10诊断为AM的275例患者中，确诊193例，其他诊断74例（26.9%）。自引入PCV以来，0-1岁儿童AM的发病率有所下降。31例临床恢复延迟，其中3例伴乙状窦血栓形成。鉴别诊断的儿童主要表现为皮肤感染或外耳炎，年龄明显大于AM患儿。结论在使用ICD-10诊断代码识别AM病例的大型回顾性研究中，需要进行图表效度评估。PCV的引入减少了2岁儿童AM病例。

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The complexity of acute mastoiditis in Swedish children

Objectives

Acute mastoiditis (AM) is a rare complication to acute otitis media (AOM) in children. Population-based studies are useful for establishing adequate treatment strategies and to evaluate the effects related to the introduction of the pneumococcal conjugate vaccine (PCV) in 2007. Previous reports however report on an overdiagnosis of AM, warranting the need for validity assessment. The aim of the present study was to assess the validity of ICD-10 diagnoses of AM and to address the differential diagnoses. Further, we aimed to map the incidence of AM over time and to specifically map the cases with delayed recovery.

Methods

A retrospective study of all hospitalized pediatric cases in Region Stockholm, Sweden, diagnosed as mastoiditis between 2003 and 2019. Case records were manually reviewed to verify the diagnosis of AM and schematically collect data.

Results

Out of 275 episodes with an ICD-10 diagnosis of AM, 193 were verified and 74 (26.9 %) had other diagnoses. The incidence of AM among children 0–1 years decreased since the introduction of PCV. Thirty-one cases displayed a delayed clinical recovery, including three cases with sigmoid sinus thrombosis. Children with a differential diagnosis, displayed mostly skin infections or otitis externa, and were significantly older than children with AM.

Conclusion

Chart validity assessment is needed in larger retrospective studies on AM where cases are identified using ICD-10 diagnosis code. The introduction of PCV has decreased the cases of AM in children <2 years.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.