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需要重症监护的结核病患者死亡的危险因素。

Risk factors for death in tuberculosis patients requiring ICU care.

机构信息

Department of Lab Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.

Department of Intensive Care Unit, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.

出版信息

Epidemiol Infect. 2021 Jan 5;149:e22. doi: 10.1017/S0950268820003106.

Abstract

The prognostic factor for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) care remains unclear. Therefore, a retrospective study was conducted aiming to estimate the in-hospital mortality rate and the risk factors for mortality in a high-burden setting. All patients with culture-confirmed TB that were admitted to the ICU of the hospital between March 2012 and April 2019 were identified retrospectively. Data, such as demographic characteristics, comorbidities, laboratory measures and mortality, were obtained from medical records. The Cox proportional hazards regression model was used to identify prognostic factors that influence in-hospital mortality. A total of 82 ICU patients with confirmed TB were included in the analysis, and 22 deaths were observed during the hospital stay, 21 patients died in the ICU. In the multivariable model adjusted for sex and age, the levels of serum albumin and white blood cell (WBC) count were significantly associated with mortality in TB patients requiring ICU care (all P < 0.01), the hazard ratios were 0.8 (95% confidence interval (CI): 0.7-0.9) per 1 g/l and 1.1 (95% CI: 1.0-1.2) per 1 × 109/l, respectively. In conclusion, in-hospital mortality remains high in TB patients requiring ICU care. Low serum albumin level and high WBC count significantly impact the risk of mortality in these TB patients in China.

摘要

在需要重症监护病房(ICU)治疗的结核病(TB)患者中,住院死亡率的预后因素仍不清楚。因此,进行了一项回顾性研究,旨在评估高负担环境下的住院死亡率和死亡风险因素。回顾性确定了 2012 年 3 月至 2019 年 4 月期间在医院 ICU 住院的所有培养确诊 TB 患者。从病历中获得数据,如人口统计学特征、合并症、实验室指标和死亡率。使用 Cox 比例风险回归模型确定影响住院死亡率的预后因素。共纳入 82 例 ICU 确诊 TB 患者,住院期间观察到 22 例死亡,21 例患者在 ICU 死亡。在调整性别和年龄的多变量模型中,血清白蛋白和白细胞(WBC)计数水平与需要 ICU 治疗的 TB 患者的死亡率显著相关(均 P<0.01),风险比分别为每 1 g/L 0.8(95%置信区间:0.7-0.9)和每 1×109/L 1.1(95%置信区间:1.0-1.2)。总之,需要 ICU 治疗的 TB 患者的住院死亡率仍然很高。低血清白蛋白水平和高 WBC 计数显著影响这些中国 TB 患者的死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754d/8057484/c11eb9cfd91e/S0950268820003106_fig1.jpg

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