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Abstract：
To investigate risk factors of misdiagnosis at the first visit of children with developmental dysplasia of the hip (DDH) who did not participate in hip ultrasound screening.
A retrospective review was conducted on children with DDH admitted to a tertiary hospital in northwestern China between January 2010 and June 2021. We divided the patients into the diagnosis and misdiagnosis groups according to whether they were diagnosed at the first visit. The basic information, treatment process and medical information of the children were investigated. We made a line chart of the annual misdiagnosis rate to observe the trend in the annual misdiagnosis rate. Univariate and multivariate logistic regression analyses were used to identify significant risk factors for missed diagnosis.
A total of 351 patients met the inclusion criteria, including 256 (72.9%) patients in the diagnosis group and 95 (27.1%) patients in the misdiagnosis group. The line chart of the annual rate of misdiagnoses among children with DDH from 2010 to 2020 showed no significant change trend. Multiple logistic regression analysis showed that the paediatrics department (v the paediatric orthopaedics department: OR 0.21, p<0.001), the general orthopaedics department (v the paediatric orthopaedics department: OR 0.39, p=0.006) and the senior physician (v the junior physician: OR 2.47, p=0.006) on the misdiagnosis at the first visit of children were statistically significant.
Children with DDH without hip ultrasound screening are prone to be misdiagnosed at their first visit. The annual misdiagnosis rate has not been significantly reduced in recent years. The department and title of the physician are independent risk factors for misdiagnosis.
A retrospective review was conducted on children with DDH admitted to a tertiary hospital in northwestern China between January 2010 and June 2021. We divided the patients into the diagnosis and misdiagnosis groups according to whether they were diagnosed at the first visit. The basic information, treatment process and medical information of the children were investigated. We made a line chart of the annual misdiagnosis rate to observe the trend in the annual misdiagnosis rate. Univariate and multivariate logistic regression analyses were used to identify significant risk factors for missed diagnosis.
A total of 351 patients met the inclusion criteria, including 256 (72.9%) patients in the diagnosis group and 95 (27.1%) patients in the misdiagnosis group. The line chart of the annual rate of misdiagnoses among children with DDH from 2010 to 2020 showed no significant change trend. Multiple logistic regression analysis showed that the paediatrics department (v the paediatric orthopaedics department: OR 0.21, p<0.001), the general orthopaedics department (v the paediatric orthopaedics department: OR 0.39, p=0.006) and the senior physician (v the junior physician: OR 2.47, p=0.006) on the misdiagnosis at the first visit of children were statistically significant.
Children with DDH without hip ultrasound screening are prone to be misdiagnosed at their first visit. The annual misdiagnosis rate has not been significantly reduced in recent years. The department and title of the physician are independent risk factors for misdiagnosis.
摘要：
目的：探讨未参与髋关节超声筛查的发育性髋关节发育不良（DDH）患儿首次就诊时误诊的危险因素。
方法：对2010年1月至2021年6月中国西北地区某三级医院收治的DDH患儿进行回顾性研究。根据首次就诊时是否确诊,将患者分为诊断组和误诊组。基本信息,对患儿的治疗过程和医疗信息进行调查。我们制作了年误诊率的线图，以观察年误诊率的趋势。单变量和多变量逻辑回归分析用于确定漏诊的显著危险因素。
结果：总共351名患者符合纳入标准，其中诊断组256例(72.9%),误诊组95例(27.1%)。2010年至2020年DDH患儿的年误诊率线图无明显变化趋势。多因素logistic回归分析显示,儿科(v儿科骨科:OR0.21,p<0.001),普通骨科（小儿骨科：OR0.39，p=0.006）和高级医师（初级医师：OR2.47，p=0.006）在儿童首次就诊时的误诊有统计学意义。
结论：没有髋关节超声筛查的DDH患儿在初次就诊时容易被误诊。近年来，每年的误诊率并未显着降低。医师的科室和职称是误诊的独立危险因素。
方法：对2010年1月至2021年6月中国西北地区某三级医院收治的DDH患儿进行回顾性研究。根据首次就诊时是否确诊,将患者分为诊断组和误诊组。基本信息,对患儿的治疗过程和医疗信息进行调查。我们制作了年误诊率的线图，以观察年误诊率的趋势。单变量和多变量逻辑回归分析用于确定漏诊的显著危险因素。
结果：总共351名患者符合纳入标准，其中诊断组256例(72.9%),误诊组95例(27.1%)。2010年至2020年DDH患儿的年误诊率线图无明显变化趋势。多因素logistic回归分析显示,儿科(v儿科骨科:OR0.21,p<0.001),普通骨科（小儿骨科：OR0.39，p=0.006）和高级医师（初级医师：OR2.47，p=0.006）在儿童首次就诊时的误诊有统计学意义。
结论：没有髋关节超声筛查的DDH患儿在初次就诊时容易被误诊。近年来，每年的误诊率并未显着降低。医师的科室和职称是误诊的独立危险因素。
