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一项国际多中心观察性研究中的失访情况。

Loss to follow-up in an international, multicentre observational study.

作者信息

Mocroft A, Kirk O, Aldins P, Chies A, Blaxhult A, Chentsova N, Vetter N, Dabis F, Gatell J, Lundgren J D

机构信息

Royal Free and University College Medical School, London, UK.

出版信息

HIV Med. 2008 May;9(5):261-9. doi: 10.1111/j.1468-1293.2008.00557.x.

Abstract

OBJECTIVE

The aim of this work was to assess loss to follow-up (LTFU) in EuroSIDA, an international multicentre observational cohort study.

METHODS

LTFU was defined as no follow-up visit, CD4 cell count measurement or viral load measurement after 1 January 2006. Poisson regression was used to describe factors related to LTFU.

RESULTS

The incidence of LTFU in 12 304 patients was 3.72 per 100 person-years of follow-up [95% confidence interval (CI) 3.58-3.86; 2712 LTFU] and varied among countries from 0.67 to 13.35. After adjustment, older patients, those with higher CD4 cell counts, and those who had started combination antiretroviral therapy all had lower incidences of LTFU, while injecting drug users had a higher incidence of LTFU. Compared with patients from Southern Europe and Argentina, patients from Eastern Europe had over a twofold increased incidence of LTFU after adjustment (incidence rate ratio 2.16; 95% CI 1.84-2.53; P<0.0001). A total of 2743 patients had a period of >1 year with no CD4 cell count or viral load measured during the year; 743 (27.1%) subsequently returned to follow-up.

CONCLUSIONS

Some patients thought to be LTFU may have died, and efforts should be made to ascertain vital status wherever possible. A significant proportion of patients who have a year with no follow-up visit, CD4 cell count measurement or viral load measurement subsequently return to follow-up.

摘要

目的

本研究旨在评估欧洲艾滋病临床数据库(EuroSIDA)这一国际多中心观察性队列研究中的失访情况。

方法

失访定义为在2006年1月1日后未进行随访、未测量CD4细胞计数或未测量病毒载量。采用泊松回归分析描述与失访相关的因素。

结果

12304例患者的失访发生率为每100人年随访3.72例[95%置信区间(CI)3.58 - 3.86;2712例失访],各国之间的失访发生率从0.67至13.35不等。调整后,年龄较大的患者、CD4细胞计数较高的患者以及开始接受联合抗逆转录病毒治疗的患者失访发生率较低,而注射吸毒者失访发生率较高。与来自南欧和阿根廷的患者相比,东欧患者调整后的失访发生率增加了两倍多(发生率比2.16;95%CI 1.84 - 2.53;P<0.0001)。共有2743例患者在一年中存在超过1年未测量CD4细胞计数或病毒载量的情况;其中743例(27.1%)随后恢复了随访。

结论

一些被认为失访的患者可能已经死亡,应尽可能努力确定其生命状态。相当一部分一年中未进行随访、未测量CD4细胞计数或未测量病毒载量的患者随后恢复了随访。

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