Complexo Hospital de Clínicas, Infectious Diseases Unit, Universidade Federal do Paraná, Curitiba, Brazil.
Complexo Hospital de Clínicas, Epidemiology Unit, Universidade Federal do Paraná, Curitiba, Brazil.
Intern Med J. 2020 Jun;50(6):691-697. doi: 10.1111/imj.14398.
Respiratory infections are one of the leading causes of mortality, and comorbid conditions play a significant role in the severity and fatality of these infections.
We evaluated the Charlson Comorbidity Index (CCI) score and possible predictors of mortality in hospitalised patients with severe acute respiratory infection (SARI), aiming to test if the CCI is a valid in-hospital prognostic indicator.
Patients older than 14 years, hospitalised from 2010 to 2016 due to SARI by viral infection and who were submitted to respiratory virus testing were included. We assessed comorbidity retrospectively through chart review and calculated four variants of the CCI.
Of the 291 patients assessed, 72.8% (n = 212) presented comorbidities, and 24% died (n = 70). The most recurrent comorbidities were chronic pulmonary disease (n = 76/212, 36%) and HIV (n = 50/212, 23.6%). The 1994 age-adjusted CCI predicted in-hospital mortality in SARI patients (P = 0.04), and HIV was associated with in-hospital mortality (P = 0.032).
The comorbidity scores used to assess mortality risk in hospitalised patients with SARI displayed poor results, but HIV infection was considered a marker of severity. However, other factors should be considered in order to compose a score system that allows us to specifically assess the risk of mortality in patients with SARI.
呼吸道感染是导致死亡的主要原因之一,合并症在这些感染的严重程度和致死率方面起着重要作用。
我们评估了 Charlson 合并症指数(CCI)评分以及与住院严重急性呼吸道感染(SARI)患者死亡相关的可能预测因素,旨在检验 CCI 是否是一个有效的院内预后指标。
纳入 2010 年至 2016 年期间因病毒感染导致 SARI 而住院,且接受呼吸道病毒检测的年龄大于 14 岁的患者。我们通过病历回顾评估合并症,并计算了 CCI 的四个变体。
在评估的 291 例患者中,72.8%(n = 212)存在合并症,24%死亡(n = 70)。最常见的合并症为慢性肺部疾病(n = 76/212,36%)和 HIV(n = 50/212,23.6%)。1994 年年龄调整后的 CCI 预测了 SARI 患者的院内死亡率(P = 0.04),HIV 与院内死亡率相关(P = 0.032)。
用于评估住院 SARI 患者死亡风险的合并症评分结果不佳,但 HIV 感染被认为是严重程度的标志物。然而,为了构建一个能够专门评估 SARI 患者死亡风险的评分系统,还应考虑其他因素。