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IBD:患有艰难梭菌感染的炎性肠病患者出院后 90天内再入院的危险因素分析

2021-03-28 MedSci原创 MedSci原创

艰难梭菌感染(CDI)被认为是一种公共卫生问题,它会导致患者住院时间,费用,死亡率和结肠切除率增加,特别是对于炎症性肠病患者来说,这样的影响更为明显。

      艰难梭菌感染(CDI)被认为是一种公共卫生问题,它会导致患者住院时间,费用,死亡率和结肠切除率增加,特别是对于炎症性肠病患者来说,这样的影响更为明显。美国有300万人患有炎症性肠病(IBD),IBD和艰难梭菌之间的关联尚不清楚,但是有研究显示炎症性肠病(IBD)患者的艰难梭菌感染(CDI)风险增加,且发病率和死亡率显着高于无IBD的患者。因此,本项研究旨在探究IBD患者住院后90天内特定疾病的再入院率和CDI感染的独立危险因素。

 

 

      本项研究共收集了50799例因IBD急性发作的患者出院后再入院的临床数据。主要观察结局是患者出院后90天内因CDI感染再入院的情况,以及患者医疗支出情况。使用Cox回归分析确定再次入院的危险因素。

 

 

      本项研究发现所有患者中90天的特定再入院率为0.1%(n = 477)。再入院时间总共有3,005天,再次入院的危险因素是机械通气> 24小时([HR],6.62,95%[CI],0.80-54.57);先前CDI感染的病史(HR,5.48; 95%CI,3.66-8.19); HIV阳性(HR,4.60; 95%CI,1.03-20.50); 酗酒(HR,2.06; 95%CI,1.15-3.70); 帕金森氏病(HR,4.68; 95%CI,1.65-13.31);复杂性溃疡性结肠炎(HR,4.49; 95%CI,2.80-7.18)。

 

 

      本项研究证实IBD复发后因CDI感染再入院的发生率为0.1%。同时研究人员也发现了与CDI相关的再次入院的风险因素,例如帕金森病的病史,既往的CDI感染史,HIV阳性状态和酗酒史。

 

 

 

原始出处:

Pedro Palacios Argueta. Et al. 90-Day Specific Readmission for Clostridium difficile Infection After Hospitalization With an Inflammatory Bowel Disease Flare: Outcomes and Risk Factors.Inflammatory Bowel Diseases.2021.

 

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    2021-03-30 bnurmamat
  2. [GetPortalCommentsPageByObjectIdResponse(id=1263640, encodeId=5da01263640dc, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Tue Mar 30 00:40:38 CST 2021, time=2021-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951935, encodeId=c791951935d3, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/gY3YO76hL0XdSxibglCL4NALkTdkawpgdFsK43DPOvtgyvAYl6lTCbnWDMBYVtNmPOp5EVGtPzLhictxE8REIcJw/132, createdBy=9b145230189, createdName=Sunny8113, createdTime=Sun Mar 28 21:48:49 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951930, encodeId=f668951930ae, content=学到很多东西,谢谢平台, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:24:33 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951929, encodeId=6d0c9519293c, content=学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:23:51 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951914, encodeId=c6379519147e, content=有用知识。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=911b2379953, createdName=hkf618, createdTime=Sun Mar 28 20:27:28 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951767, encodeId=4752951e67e6, content=学到了很多东西谢谢老师, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c5b3006368, createdName=1436749007, createdTime=Sun Mar 28 09:51:47 CST 2021, time=2021-03-28, status=1, ipAttribution=)]
    2021-03-28 Sunny8113

    受益匪浅

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1263640, encodeId=5da01263640dc, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Tue Mar 30 00:40:38 CST 2021, time=2021-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951935, encodeId=c791951935d3, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/gY3YO76hL0XdSxibglCL4NALkTdkawpgdFsK43DPOvtgyvAYl6lTCbnWDMBYVtNmPOp5EVGtPzLhictxE8REIcJw/132, createdBy=9b145230189, createdName=Sunny8113, createdTime=Sun Mar 28 21:48:49 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951930, encodeId=f668951930ae, content=学到很多东西,谢谢平台, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:24:33 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951929, encodeId=6d0c9519293c, content=学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:23:51 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951914, encodeId=c6379519147e, content=有用知识。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=911b2379953, createdName=hkf618, createdTime=Sun Mar 28 20:27:28 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951767, encodeId=4752951e67e6, content=学到了很多东西谢谢老师, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c5b3006368, createdName=1436749007, createdTime=Sun Mar 28 09:51:47 CST 2021, time=2021-03-28, status=1, ipAttribution=)]
    2021-03-28 1486adbfm03暂无昵称

    学到很多东西,谢谢平台

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1263640, encodeId=5da01263640dc, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Tue Mar 30 00:40:38 CST 2021, time=2021-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951935, encodeId=c791951935d3, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/gY3YO76hL0XdSxibglCL4NALkTdkawpgdFsK43DPOvtgyvAYl6lTCbnWDMBYVtNmPOp5EVGtPzLhictxE8REIcJw/132, createdBy=9b145230189, createdName=Sunny8113, createdTime=Sun Mar 28 21:48:49 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951930, encodeId=f668951930ae, content=学到很多东西,谢谢平台, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:24:33 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951929, encodeId=6d0c9519293c, content=学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9e3f5293425, createdName=1486adbfm03暂无昵称, createdTime=Sun Mar 28 21:23:51 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951914, encodeId=c6379519147e, content=有用知识。, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=911b2379953, createdName=hkf618, createdTime=Sun Mar 28 20:27:28 CST 2021, time=2021-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951767, encodeId=4752951e67e6, content=学到了很多东西谢谢老师, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c5b3006368, createdName=1436749007, createdTime=Sun Mar 28 09:51:47 CST 2021, time=2021-03-28, status=1, ipAttribution=)]
    2021-03-28 1486adbfm03暂无昵称

    学习啦

    0

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    2021-03-28 hkf618

    有用知识。

    0

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    2021-03-28 1436749007

    学到了很多东西谢谢老师

    0

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年轻患者炎症性肠病(IBD)的发病率,例如克罗恩病(CD)和溃疡性结肠炎(UC),在世界范围内正在增加。多达20%的IBD病例在18岁之前被诊断出。

JCC:炎症性肠病患者会导致结肠癌诊断时间提前但是预后较差

炎症性肠病[IBD]是结肠癌的已知危险因素,占大肠癌[CRC]的1-2%左右。纵向研究表明,结肠炎症的程度,肠蠕动时间以及原发性硬化性胆管炎是CRC发生的前期疾病。

Gastroenterology:炎症性肠病的妇女接受生物制剂和硫唑嘌呤治疗对于新生儿结局的影响

有研究显示患有炎症性肠病(IBD)的孕妇更容易发生自然流产(SAB),早产,以及分娩和分娩期间的并发症的出现。因此,需要用药物治疗保持怀孕期间的病情稳定。

TAG: 治疗炎症性肠病的抗肿瘤坏死因子也会诱发狼疮的发生

由克罗恩病(CD)和溃疡性结肠炎(UC)构成的炎症性肠病(IBD)是胃肠道的一种慢性炎症性疾病。

JAMA Network Open:抗肿瘤坏死因子(TNF)治疗和炎症性肠病患者全因死亡率之间是否相关?

炎症性肠病(IBD)通常用皮质类固醇和抗肿瘤坏死因子(TNF)药物治疗。然而,药物使用过程中有很多患者描述了不良反应。

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