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因病毒性肺炎住院的成年患者结局中的种族差异。

Racial Disparities in Outcomes of Adults Hospitalized for Viral Pneumonia.

作者信息

Ojemolon Pius E, Trelles-Garcia Valeria P, Trelles-Garcia Daniela, Kichloo Asim, Raghavan Sairam, Abusalim Abdulrahman I, Eseaton Precious

机构信息

Anatomical Sciences, St. George's University, St. George's, GRD.

Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.

出版信息

Cureus. 2020 Dec 4;12(12):e11909. doi: 10.7759/cureus.11909.

Abstract

Background Viral pneumonia is an important cause of respiratory morbidity and mortality. Cases of viral pneumonia are becoming increasingly more common as at-risk populations increase globally. We sought to highlight the racial distribution of hospitalized patients with viral pneumonia and compare their outcomes. Materials and methods Data were obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. The study involved adults who had a principal discharge diagnosis of viral pneumonia. The primary outcome analyzed was inpatient mortality. Secondary outcomes included the development of sepsis, septic shock, acute respiratory failure, acute respiratory distress syndrome, non-ST segment elevation myocardial infarction (NSTEMI), acute kidney failure, deep vein thrombosis, pulmonary embolism, cerebrovascular accident, need for mechanical ventilation, and use of vasopressors as well as mean length of hospitalization and mean total hospital charges. Results Blacks and Hispanics had lower inpatient mortality adjusted odds (aOR: 0.39, 95% CI = 0.229 - 0.662, p<0.001 and aOR: 0.55, 95% CI = 0.347 - 0.858, p=0.009, respectively) compared to Whites. Black and Hispanic patients were also found to have lower adjusted odds ratio of having acute respiratory failure (aOR: 0.54, 95% CI = 0.471 - 0.614, p<0.001, and 0.66, 95% CI = 0.576 - 0.753, p<0.001, respectively). Conclusion Black and Hispanic patients are at lower risk of adverse outcomes when compared to White patients with viral pneumonia.

摘要

背景

病毒性肺炎是导致呼吸疾病发病和死亡的重要原因。随着全球高危人群的增加,病毒性肺炎病例越来越普遍。我们试图强调住院病毒性肺炎患者的种族分布,并比较他们的治疗结果。

材料和方法

数据来自2016年和2017年的全国住院患者样本(NIS)。该研究纳入了主要出院诊断为病毒性肺炎的成年人。分析的主要结局是住院死亡率。次要结局包括脓毒症、感染性休克、急性呼吸衰竭、急性呼吸窘迫综合征、非ST段抬高型心肌梗死(NSTEMI)、急性肾衰竭、深静脉血栓形成、肺栓塞、脑血管意外、机械通气需求、血管升压药的使用以及平均住院时间和平均总住院费用。

结果

与白人相比,黑人和西班牙裔患者的住院死亡率调整优势比更低(调整优势比分别为:0.39,95%置信区间=0.229 - 0.662,p<0.001;以及0.55,95%置信区间=0.347 - 0.858,p=0.009)。还发现黑人和西班牙裔患者发生急性呼吸衰竭的调整优势比也更低(调整优势比分别为:0.54,95%置信区间=0.471 - 0.614,p<0.001;以及0.66,95%置信区间=0.576 - 0.753,p<0.001)。

结论

与患病毒性肺炎的白人患者相比,黑人和西班牙裔患者出现不良结局的风险更低。

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The impact of ethnicity on clinical outcomes in COVID-19: A systematic review.种族对新冠病毒病临床结局的影响:一项系统评价
EClinicalMedicine. 2020 Jun 3;23:100404. doi: 10.1016/j.eclinm.2020.100404. eCollection 2020 Jun.

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