Friedman Y, Franklin C, Freels S, Weil M H
Department of Medicine, Cook County Hospital, Chicago, Ill 60612.
JAMA. 1991 Jul 3;266(1):89-92.
--To evaluate the long-term survival of patients admitted to the medical intensive care unit, Cook County Hospital, Chicago, Ill, with Pneumocystis carinii pneumonia and acute respiratory failure.
--Cohort study over a 4-year period.
--Municipal teaching hospital.
--Seventy-three consecutive patients who had 75 episodes of P carinii pneumonia and acute respiratory failure were followed up from the time of hospital admission until their deaths or the termination of the study.
--Duration of survival from the time of initial hospital admission with diagnoses of P carinii pneumonia and acute respiratory failure.
--Consistent with recent reports of improved short-term outcome, the immediate hospital survival was 47% (35/75). The 1-year survival was 37% (95% confidence interval, 26% to 49%). Two patients have survived for 40 months. Almost three quarters of the patients who survived hospitalization lived for at least 1 year.
--The long-term prognosis for patients with the acquired immunodeficiency syndrome, P carinii pneumonia, and acute respiratory failure is now substantially better than anticipated. Respiratory failure due to P carinii pneumonia does not necessarily signify the terminal phase of human immunodeficiency virus infection. Accordingly, patients with the acquired immunodeficiency syndrome, P carinii pneumonia, and acute respiratory failure can be appropriate candidates for life support in medical intensive care units.
评估入住伊利诺伊州芝加哥市库克县医院内科重症监护病房、患有卡氏肺孢子虫肺炎和急性呼吸衰竭的患者的长期生存率。
为期4年的队列研究。
市立教学医院。
连续73例患者发生75次卡氏肺孢子虫肺炎和急性呼吸衰竭，从入院时起直至死亡或研究结束进行随访。
自初次因卡氏肺孢子虫肺炎和急性呼吸衰竭入院起的生存时间。
与近期关于短期预后改善的报道一致，住院即刻生存率为47%（35/75）。1年生存率为37%（95%置信区间，26%至49%）。两名患者存活了40个月。几乎四分之三存活出院的患者存活至少1年。
获得性免疫缺陷综合征、卡氏肺孢子虫肺炎和急性呼吸衰竭患者的长期预后现在比预期要好得多。卡氏肺孢子虫肺炎所致呼吸衰竭不一定意味着人类免疫缺陷病毒感染的终末期。因此，获得性免疫缺陷综合征、卡氏肺孢子虫肺炎和急性呼吸衰竭患者可能适合在内科重症监护病房接受生命支持治疗。
