分析 vanB 型万古霉素耐药肠球菌菌血症作为时变协变量对住院时间的影响。
Impact of vanB vancomycin-resistant enterococcal bacteraemia analysed as a time-varying covariate on length of hospital stay.
机构信息
Centre for Medicine Use and Safety,Monash University,Parkville, Victoria,Australia.
Centre for Population Health,Burnet Institute,Prahran, Victoria,Australia.
出版信息
Epidemiol Infect. 2014 Dec;142(12):2667-71. doi: 10.1017/S095026881400020X.
The impact of vanB vancomycin-resistant enterococci (VRE) bacteraemia on length of stay (LOS) in hospital, after adjusting for the time-varying nature of enterococcal bacteraemia (variable onset of bacteraemia post-admission), is unknown. Survival analyses (time-varying Cox and competing risks regression) were performed on vanB VRE bacteraemia patients, matched 1:1 with vancomycin-susceptible enterococci bacteraemia patients to determine the factors associated with LOS in these patients. In Cox regression analysis, vanB VRE bacteraemia, intensive-care-unit admission, Charlson co-morbidity index score ⩾4, and an increase in the time to receive appropriate antibiotics were associated with prolonged LOS. Competing risks regression which accounts for the influence of in-patient mortality on the ability to observe the event discharge alive from hospital suggests that, vanB VRE bacteraemia was not significantly associated with prolonged LOS. For the first time, the rate of discharge from hospital in patients with vanB VRE bacteraemia has been quantified.
在调整肠球菌菌血症的时变性质（即入院后菌血症的起始时间变化）后，vanB 型万古霉素耐药肠球菌（VRE）菌血症对住院时间（LOS）的影响尚不清楚。对 vanB 型 VRE 菌血症患者进行生存分析（时变 Cox 和竞争风险回归），并与万古霉素敏感肠球菌菌血症患者 1:1 匹配，以确定与这些患者 LOS 相关的因素。在 Cox 回归分析中，vanB 型 VRE 菌血症、重症监护病房（ICU）入院、Charlson 合并症指数评分 ⩾4 以及接受适当抗生素的时间增加与 LOS 延长相关。竞争风险回归考虑了住院患者死亡率对观察从医院出院存活这一事件的能力的影响，提示 vanB 型 VRE 菌血症与 LOS 延长无显著相关性。首次定量分析了 vanB 型 VRE 菌血症患者的出院率。
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