Analysis On The Impact Factors Of Delayed Diagnosis Cases

Developmental Dysplasia of the hip (DDH) is one of the most common children's skeletal system diseases, the definition of it is that DDH can make femoral head and acetabulum in the development and / or anatomical relations unusual series of hip disease before birth and after birth.At present, China's no relatively authority materials of DDH, the incidence reported is not the same, the south incidence is lower , and the north's is higher. The incidence of neonatal is fluctuate from0.07‰to 1.75‰.DDH is one of serious disease which can obstruct the normal growth of children and it also can affect their normal life and work as they be adult. However, most children come to hospital elderly, not only affected the treatment, but treatment itself also caused great suffering, in addition, the treatment also increased the financial burden on the families of patients and a new IICA expenditure. So the early diagnosis and early treatment of DDH is significantly important and is the key to control disease and gets good results .This paper reviewed many DDH patients in an orthopaedic hospital of Henan from 2003 to 2007. Analysis of the impact of early diagnosis and treatment of DDH relevant factors, with a view to providing targeted measures to reduce delayed diagnosis, improve early diagnosis and early treatment of proportion. 1 Study objective1.1 Study object 567 cases in an orthopaedic hospital of all the DDH from 2003 to 2007, the youngest is one month, the elderst is 12-year-old.1.2 Diagnostic criteria of DDH according to the diagnostic criteria for pediatric bone science diagnosis standards.2 Research content2.1 Sick type dislocation unilateral, bilateral dislocation, subluxation.2.2 Personal information sex, age, parity, abnormal fetal position, place of birth, birth season.2.3 Family history three generations of genetic and collateral genetically has/no the same patients.2.4 Family circumstances parents education, employment, family individual income, registered permanent residence.2.5 Prenatal care and child health care conditiong of B-fetal, newborn screening, newborn visiting, and the parental upbringing, dependency and the relationship between the children.2.6 Local medical conditions initial hospital-level.2.7 Clinical disease discovery clinical performance.2.8Diagnosis and treatment days of hospitalization , treatment surgical sites, efficacy.3 Method3.1 Data collection and input Search for all cases from computer management system in January 2003 to December 2007 in an orthopaedic specialist hospital medical record hospital, check relevant information and improve the tables, and add omitted cases, with the two results to ensure information integrity and accurate. Epidata3.0 the establishment of a database of information used by the double after double entry data consistency and logic verification, and 5% of the randomly selected data entry review, and strictly control the quality of data entry, in order to ensure the accuracy of the database. 3.2 Standard of early diagnosis and delayed diagnosis With the age limite standards of this disease in this hospial, its divided by surgery and non-surgical therapy. The age within 2 years definite as early diagnosis, age more than 2 years definite as delayed diagnosis.3.3 The early diagnosis group for the control group, the delayed diagnosis group for the observation group, analysis relevant factors.3.4 Statistics analysis The data were analyzed by software SPSS 12.0 to achieve the incidence of DDH, including infection rate, x~2, P, OR, OR95%CI. And Logistic results. a=0.05 was considered as level of a test.4 Results4.1 Between January 2003 to December 2007 in an orthopaedic specialist hospital for diagnosis and treatment of DDH all hospitalized cases, a total of 567 cases. Female 428 cases, accounting for 75.49 %, 139 cases of male, accounting for 24.51%. Male to female ratio was 1:3.08. The oldest isl2 years old, the youngest is one month, the average is 3.59 years. Early diagnosis were found in 240 cases, accounting for 42.33 % of the cases observed; 327 cases of delayed diagnosis, accounting for 57.67 % of the cases observed. Most foreignal research think that less than three months as the early diagnosis standard ,In Shanghai, - within 10 months after bone be difined as the early diagnosis, in this study as a 2-year-old paper to the early diagnosis and delayed diagnosis of the line,4.2 In all 567 investigations cases, March to August born 162 cases, accounting for 28.57%. September to February born 405 cases, accounting for 71.43%. September to February born is March to August born 2.5 times. Born in January 85 cases,is the largest of birth. Born in May 15 cases, at least. Cases born in January are the cases in May born nearly six times.4.3 The paper analyzed: Sex, prevalence of the other side, parity, and season of birth, place of birth, parent education, occupation, family income, clinical manifestations, confirmed the hospital. The results of these six factors (sex, prevalence of the other side, parents education, family income, confirmed the hospital, clinical performance) early diagnosis group and the delayed diagnosis of the differences between the groups was significant;4.4 Logistic regression analysis The independent risk factors of early diagnosis of DDH were: education level of their parents, the other side of the prevalence, clinical performance.ConclusionsEarly diagnosis can be less than half of the cases. Family education, clinical performance performance, prevalence of other side were effects for the early diagnosis of the main factors.Only 0.5 % of newborns received the DDH screening, called for DDH routine screening of all newborns.Patients had the following characteristics: the right side of cases were more than the left side of cases. Children with female were far more than male children. In the cold season DDH-born children were more number of cases.