背景:在怀疑狂犬病暴露(SRE)和狂犬病暴露后预防(R-PEP)的潜在需要后,经常去急诊室(ED)。然而,访问次数数据,患者的人口统计学,旅行史和医疗仍然很少。因此,这项研究的目的是评估R-PEP的数量和包括伤口治疗在内的医疗管理的适当性,在一所大学医院ED进行SRE后的疫苗接种方案和免疫球蛋白应用。
方法:我们对在LMU大学医院急诊科治疗的急诊患者进行了单中心回顾性观察研究,路德维希-马克西米利安大学慕尼黑,德国,2023年6月1日至2024年1月31日。包括由于国外或德国的SRE而需要暴露后预防的患者。人口统计数据,旅行史,临床发现,伤口治疗,并记录R-PEP疫苗接种方案。
结果:在245天的观察期间,有43例患者因R-PEP接受了我们的ED。总共有51个介绍任命,5名患者返回接受进一步治疗。大多数患者(27,52.9%)在星期六在ED上就诊,周日,或公众假期。17例(39.5%)患者有II类暴露,26人(60.5%)有III类暴露。在我们的ED中,有28例(55.0%)主动接种和23例(45.0%)主动和被动接种.
结论:我们的数据表明,ED患者经常出现R-PEP。因此,对于R-PEP适应症的教育以及在日常临床实践中实施精确的R-PEP治疗指南的需求非常高.
BACKGROUND: Emergency departments (ED) are frequently visited after suspected rabies exposure (SRE) and the potential need for rabies post-exposure prophylaxis (R-PEP). However, data on the number of visits, patients\' demographics, travel history and the medical treatment is still rare. Therefore, the aim of this study was to assess the number of R-PEP and the appropriateness of medical management including wound treatment, vaccination regime and immunoglobulin application following SRE in a university hospital ED.
METHODS: We conducted a monocentric retrospective observational study on emergency patients treated in the ED of the LMU University Hospital, Ludwig-Maximilians-University Munich, Germany, between June 1st, 2023 and January 31st, 2024. Patients requiring post-exposure prophylaxis due to SRE abroad or in Germany were included. Demographic data, travel history, clinical findings, wound treatment, and R-PEP vaccination regimen were recorded.
RESULTS: During the observation period of 245 days 43 patients presented to our ED for R-PEP. There was a total of 51 presentation appointments, as 5 patients returned for further treatment. Most patients (27, 52.9 %) presented at the ED on a Saturday, Sunday, or a public holiday. 17 (39.5 %) patients had a category II exposure, and 26 (60.5 %) had a category III exposure. In our ED, there were 28 (55.0 %) active vaccinations and 23 (45.0 %) both active and passive vaccinations.
CONCLUSIONS: Our data show that patients frequently present for R-PEP in ED. Therefore, there is a high need for education on indication for R-PEP and for implementation of precise R-PEP treatment guidelines in daily clinical practice.