Oh Hong Geun, Cha Seung-Ick, Shin Kyung-Min, Lim Jae-Kwang, Kim Hyun Jung, Yoo Seung-Soo, Lee Jaehee, Lee Shin-Yup, Kim Chang-Ho, Park Jae-Yong
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
J Infect Chemother. 2016 Aug;22(8):553-8. doi: 10.1016/j.jiac.2016.05.008. Epub 2016 Jun 23.
Data regarding prognostic factors for patients with septic pulmonary embolism (SPE) are lacking. The purpose of the present study was to investigate the clinical features of SPE and to ascertain the risk factors for mortality in patients with this condition. Patients with SPE, whose data were retrospectively collected from a tertiary referral center in Korea, were categorized by the presence or absence of in-hospital death into two groups: death and survival groups. The two groups were compared for clinical and radiologic parameters. SPE was community-acquired in most patients (78%). The most common focus of primary infection was that of bone, joint, or soft tissue (33%), followed by liver abscess (17%). The in-hospital mortality was 12%. Multivariate analysis showed that tachypnea (odds ratio [OR] 4.73, 95% confidence interval [CI] 1.09-20.53, p = 0.038) and segmental or lobar consolidation on computed tomography (CT) scan (OR 10.79, 95% CI 2.51-46.43, p = 0.001) were independent predictors of in-hospital death in SPE patients. Taken together, the primary infectious foci of SPE in Korea are different from those reported in Western countries. Tachypnea and segmental or lobar consolidation on CT scan may be independent risk factors for in-hospital death in these patients.
关于脓毒性肺栓塞(SPE)患者预后因素的数据尚缺。本研究旨在调查SPE的临床特征,并确定该疾病患者的死亡危险因素。从韩国一家三级转诊中心回顾性收集数据的SPE患者,根据住院期间是否死亡分为两组:死亡组和存活组。比较两组的临床和影像学参数。大多数患者(78%)的SPE为社区获得性。原发性感染最常见的病灶是骨、关节或软组织(33%),其次是肝脓肿(17%)。住院死亡率为12%。多因素分析显示,呼吸急促(比值比[OR]4.73,95%置信区间[CI]1.09 - 20.53,p = 0.038)和计算机断层扫描(CT)显示节段性或大叶性实变(OR 10.79,95% CI 2.51 - 46.43,p = 0.001)是SPE患者住院死亡的独立预测因素。综上所述,韩国SPE的原发性感染灶与西方国家报道的不同。呼吸急促和CT显示节段性或大叶性实变可能是这些患者住院死亡的独立危险因素。