Chen Shey-Ying, Tsai Chu-Lin, Lin Chien-Hao, Lee Chien-Chang, Chiang Wen-Chu, Wang Jiun-Ling, Ma Matthew Huei-Ming, Chen Shyr-Chyr, Chen Wen-Jone, Chang Shan-Chwen
Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Diagn Microbiol Infect Dis. 2009 Jun;64(2):124-30. doi: 10.1016/j.diagmicrobio.2009.01.008. Epub 2009 Mar 21.
Few studies have analyzed the impact of liver cirrhosis, a clinically significant comorbid medical condition, on the mortality of patients with community-acquired bacteremia. We conducted an observational study of 839 consecutive community-acquired bacteremia patients who were hospitalized through the emergency department (ED). We compared the 30-day mortality of bacteremia patients with and without liver cirrhosis using Cox proportional hazards regression. The probability of survival at day 30 was significantly different for the cirrhotic and noncirrhotic groups (53% versus 82%, respectively; P < 0.001 by the log-rank test). Multivariate analysis indicated that liver cirrhosis was associated with an increased risk of short-term mortality (hazard ratio, 2.0; 95% confidence interval, 1.1-3.5), as well as age, higher comorbidity index, and markers obtained from clinical presentation at ED. In conclusion, in addition to the effects from other prognostic factors, liver cirrhosis has a significant impact on the mortality of patients with community-acquired bacteremia.
很少有研究分析肝硬化这一具有临床意义的合并症对社区获得性菌血症患者死亡率的影响。我们对839例通过急诊科住院的连续社区获得性菌血症患者进行了一项观察性研究。我们使用Cox比例风险回归比较了有肝硬化和无肝硬化菌血症患者的30天死亡率。肝硬化组和非肝硬化组在第30天的生存概率有显著差异（分别为53%和82%；对数秩检验P<0.001）。多变量分析表明，肝硬化与短期死亡风险增加相关（风险比为2.0；95%置信区间为1.1 - 3.5），同时还与年龄、更高的合并症指数以及在急诊科临床表现所获得的指标有关。总之，除了其他预后因素的影响外，肝硬化对社区获得性菌血症患者的死亡率有显著影响。
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