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首页> 外文期刊>Emerging Infectious Diseases >Hospital Discharge Data for Guillain-Barré Syndrome and Influenza A (H1N1) Vaccine Adverse Events
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Hospital Discharge Data for Guillain-Barré Syndrome and Influenza A (H1N1) Vaccine Adverse Events

机译：格林-巴利综合征和甲型H1N1流感疫苗不良事件的出院数据

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To the Editor: As part of the public health response to the current pandemic (H1N1) 2009, surveillance for adverse events following vac-cination for in. uenza A (H1N1) is a high priority (1). Surveillance for Guillain-Barré syndrome (GBS) has been of particular interest, because the syndrome was associated with the 1976–1977 swine in. uenza vaccine (1,2). To study this association, reli-able ascertainment of recent incident cases of GBS is necessary. GBS is an acute, immune-me-diated paralytic disorder of the pe-ripheral nervous system (3–5) with an estimated annual incidence of 0.8–1.9/100,000 (6). Most cases are associated with an antecedent infec-tion (6). Several surveillance systems are in place to monitor rates of post-vaccination GBS (1–3), most of which include a component of electronic administrative record review for case detection. Analysis of computerized medical databases is a well-established method of monitoring for vaccine ad-verse events (7). Although the validity of such data varies, depending on the diagnosis and region, few studies have evaluated the use of hospital discharge data for GBS specifi cally (8,9).We reviewed the Tennessee De-partment of Health Uniform Hospi-tal Discharge Dataset for all hospi-tal discharge diagnoses in 4 major metropolitan regions of Tennessee in 2002–2003 with codes from the In-ternational Classifi cation of Diseases, 9th Revision, Clinical Modifi cation (ICD-9-CM), that might indicate acute GBS. Records with ICD-9-CM code 357.0 (acute infective polyneuritis) or other combinations suggestive of GBS within the top 10 diagnoses were requested. These data were compared with information on cases identifi ed by directly requesting lists of patients with discharge diagnoses of GBS from hospital medical record departments. Charts of all reported cases were vali-dated by chart review. Patients were classifi ed as having acute GBS if they met Brighton Criteria Levels 1, 2, or 3 (10).
机译：致编辑：作为对当前2009年H1N1大流行的公共卫生应对措施的一部分，将流感A疫苗（H1N1）疫苗接种后的不良事件进行监视是当务之急（1）。对吉兰-巴雷综合症（GBS）的监视尤其引起关注，因为该综合症与1976-1977年的猪流感疫苗相关（1,2）。为了研究这种关联，必须对最近发生的GBS事件进行可靠的确定。 GBS是一种急性，免疫介导的周围神经系统麻痹性疾病（3-5），估计年发病率为0.8-1.9 / 100,000（6）。大多数情况与先发感染有关（6）。已经建立了几个监视系统来监视疫苗接种后GBS的发生率（1-3），其中大多数包括用于病例检测的电子行政记录审查的组成部分。计算机医学数据库的分析是一种监测疫苗不良事件的行之有效的方法（7）。尽管此类数据的有效性各不相同，但根据诊断和地区的不同，很少有研究评估特定GBS的医院出院数据的使用情况（8,9）。我们回顾了田纳西州卫生统一医院出院数据集对于2002-2003年田纳西州4个主要都会区的所有医院出院诊断，均采用国际疾病分类（第9版，临床修改）（ICD-9-CM）中的代码，可能表明存在急性GBS。要求记录前10次诊断中具有ICD-9-CM代码357.0（急性感染性多发性神经炎）或其他暗示GBS的组合的记录。将这些数据与直接从医院病历部门索取GBS出院诊断的患者名单中确定的病例信息进行比较。通过图表审查对所有报告病例的图表进行验证。如果患者符合布莱顿标准第1、2或3级，则被分类为急性GBS（10）。

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