目的:本研究确定了晚期位置性错头症(PP)诊断的危险因素以及对头盔治疗的影响。
方法:我们对南加州五家医院诊断为PP的所有患者进行了10年以上的回顾性研究。
方法:在纳入的医院诊断为PP的患者。
方法:25,332例患者诊断为PP超过10年。
方法:比较早期(<=6个月)和晚期(>6个月)诊断为PP的患者。
方法:对队列进行了人口统计学评估,妊娠史,相关条件,通过直接比较和住院,逻辑回归,和相关分析。比较了推荐率和头盔订单率。
结果:回顾的患者,4.8%(n=1216)被诊断为晚期。在多变量分析中,晚期诊断更可能是西班牙裔或黑人/非裔美国人.早期胎龄,脑积水,在晚期诊断中,VP分流更为常见。晚期诊断的患者NICU和整体住院时间更长。胎龄较早,NICU或总住院时间延长与PP诊断年龄晚相关.8.9%的患者接受头盔治疗评估。晚期诊断的患者转诊的可能性分别为2.63和1.64倍,需要头盔治疗。分别。
结论:西班牙裔或黑人/非裔美国人患者,过早,有脑积水,或VP分流有较高的延迟PP诊断率。更短的胎龄或更长的NICU或住院时间与后期诊断相关,这增加了头盔治疗的要求。对于有风险的患者,需要额外的干预措施来常规评估并最小化发生PP的风险。
OBJECTIVE: This study identifies risk factors for late positional plagiocephaly (PP) diagnosis and impact on helmet therapy.
METHODS: We conducted a retrospective
review of all patients diagnosed with PP over 10 years at five Southern California hospitals.
METHODS: Patients diagnosed with PP at an included hospital.
METHODS: 25,332 patients were diagnosed with PP over 10 years.
METHODS: Patients diagnosed with PP early (< = 6 months) and late (>6 months) were compared.
METHODS: Cohorts were evaluated for demographics, gestational history, associated conditions, and hospitalizations through direct comparison, logistic regression, and correlation analyses. Rates of referrals and helmet orders were compared.
RESULTS: Of patients reviewed, 4.8% (n = 1216) were diagnosed late. On multivariate analysis, late diagnoses were more likely Hispanic or Black/African-American. Early gestational age, hydrocephalus, and VP shunt were more frequent in late diagnoses. Patients diagnosed late had longer NICU and overall hospital stays. Earlier gestational age, longer NICU or overall hospital stay correlated with later age at PP diagnosis. 8.9% of patients were referred for helmet therapy evaluation. Patients diagnosed late were 2.63 and 1.64 times as likely to be referred and require helmet therapy, respectively.
CONCLUSIONS: Patients who are Hispanic or Black/African-American, premature, have hydrocephalus, or VP shunt have higher rates of delayed PP diagnosis. Shorter gestational age or longer NICU or hospital stay correlates with later diagnosis, which increases helmet therapy requirements. Additional interventions are needed for at risk patients to routinely evaluate for and minimize the risk of developing PP.