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AJRCCM:十年间社区获得性肺炎(CAP)的死亡率研究

2015-07-06 徐媛媛译 MedSci原创

社区获得性肺炎(CAP)的长期预后研究数据是有限的。本研究观察了社区获得性肺炎(CAP)的十年死亡率并探讨CAP是否会增加长期不良结局。 在2000-2002年间,研究人员收纳了来自加拿大6家医院和7个急诊科的6078例CAP患者,以及收纳了与年龄、性别和治疗地点相匹配的5个非肺炎人群的对照组(n=29402)。通过调整社会经济地位和合并症,使用多变量Cox比例风险分析评估了到2012年的死亡率

社区获得性肺炎(CAP)的长期预后研究数据是有限的。本研究观察了社区获得性肺炎(CAP)的十年死亡率并探讨CAP是否会增加长期不良结局。

在2000-2002年间,研究人员收纳了来自加拿大6家医院和7个急诊科的6078例CAP患者,以及收纳了与年龄、性别和治疗地点相匹配的5个非肺炎人群的对照组(n=29402)。通过调整社会经济地位和合并症,使用多变量Cox比例风险分析评估了到2012年的死亡率、住院率和急诊就诊率。

平均年龄为59岁[2682名(44%)65岁],3214名(53%)为男性,3425名(56%)为门诊患者。平均随访时间为9.8年,2858名CAP患者死亡,对照组有9399名患者死亡(绝对风险差异为30/1000人年;调整后的危险比aHR为1.65,95%CI 1.57-1.73,p<0.001)。CPA患者<25岁的死亡率最低(4/1000人年;aHR 1.42),CPA患者>80岁的死亡率的绝对差异最大(92/1000人年;aHR 1.42)。与对照组相比,CAP患者的全因住院率、急诊就诊率、CAP相关就诊率都明显增加(P<0.001)。

研究结果表明,与未患过CAP的人群相比,经历过CAP的患者出现长期不良事件的风险升高,这与年龄无关。

原始出处

Eurich DT1, Marrie TJ2, Minhas-Sandhu JK3, Majumdar SR4.Ten Year Mortality Following Community Acquired Pneumonia: A Prospective Cohort.Am J Respir Crit Care Med. 2015 Jun 11

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    2016-05-15 smlt2008
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    2016-01-03 三三五五

    0

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    2015-10-17 isabellayj
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    2015-07-08 huaxipanxing

    看看

    0

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J Dent Res:睡觉时佩戴假牙可增加老年人患肺炎的风险越来越多人意识到不良的口腔卫生是老年人肺炎的主要危险因素。为了确定多种口腔健康相关的危险因素,我们采用了前瞻性研究以评估社区老年人群(年龄在85岁及以上)中一系列的口腔健康行为与肺炎发生率之间可能存在的关系。研究开始随机选择了524名老年人(228名男性和296名女性;平均年龄为87.8岁),检查各研究对象的口腔卫生状况,记录其口腔健康行

Pediatrics:超声可准确诊断小儿肺炎

欲寻求小儿肺炎诊断替代方法的儿科医生或将多一有效诊断方法——肺部超声(LUS)。美国儿科学会会刊《儿科学》(Pediatrics)3月16日在线发布的一项荟萃分析显示,经培训的医生应用LUS诊断肺炎的特异性和灵敏度高。肺炎是导致全球儿童死亡的首位原因。但由于年龄及感染原因各异,患儿呈现的症状也各不相同,因此导致小儿肺炎的诊断尤为困难。此外,部分症状并不能排除小儿肺炎,却可能提示存在其他疾病。医生常

PD-1抗体,疗效虽好,但也要担心肺炎副作用

特别提醒使用PD1抗癌的患者注意可能的副作用-肺炎,临床试验中出现了因肺炎致死的病例,尤其是有肺部病史的非小细胞肺癌患者,出门的时候最好戴口罩,防止感染。我们总结了PD1抗体临床试验中肺炎发生的情况和日本的《PD1使用指南》中肺炎的发生和处理方法,以及一部分具体实例供参考,希望能帮到大家。 PD1临床试验中现肺炎副作用出现的比例 4月19号的《新英格兰医学杂志》发表的关于使用默克的PD

AJRCCM:对大环内酯类耐药不能证明肺炎患者预后不佳

背景:关于使用大环内酯类药物在治疗肺炎链球菌肺炎疾病时,患者的临床表现和预后至今在许多研究中尚存在争议。研究方式:我们在西班牙巴塞罗那所有医院中进行了一项回顾性、观察性的研究,研究对象是2000年1月1日到2013年12月31日诊所内所有肺炎链球菌培养结果阳性的成年住院患者。我们观察的主要指标包括患者发生菌血症、肺部并发症、急性肾功能衰竭、休克、转入ICU、需要呼吸机辅助通气的患者人数及比例,此外

Lancet:接受适当初始抗生素治疗的肺炎患者的30天死亡率风险因素分析

    适当的初始抗生素治疗感染性疾病是必不可少的。然而,尽管接受适当的初始抗生素治疗,一些肺炎的患者仍然可能会出现不利的结果。该研究的目的是明确在接受适当的初始抗生素治疗的患者30天的死亡率的风险因素,并确定受益于辅助治疗潜在的候选人。    从2010年3月15日至12月22日,研究人员在十家医疗机构对因肺炎入院的患者(年龄≥20岁)做了一项前瞻性观察研

NEJM:多糖+疫苗对抗肺炎球菌肺炎

背景 肺炎球菌多糖结合疫苗预防婴幼儿肺炎球菌疾病,但他们对65岁及以上成年人或老年人社区获得性肺炎的疗效是未知的。 方法 在一项随机,双盲,安慰剂对照试验,涉及84496名65岁或以上成年人,我们评估了13价多糖结合疫苗(PCV13)有效预防肺炎球菌疫苗株的第一次社区获得性肺炎,菌血症性和非侵入性肺炎球菌肺炎和侵袭性肺炎球菌疾病。标准的实验室方法和血清型特异性尿抗原检测用来确定社区获得性肺炎和

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