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原发性和复发性感染患者的临床并发症:一项真实世界数据分析。

Clinical complications in patients with primary and recurrent infection: A real-world data analysis.

作者信息

Feuerstadt Paul, Boules Mena, Stong Laura, Dahdal David N, Sacks Naomi C, Lang Kathleen, Nelson Winnie W

机构信息

Gastroenterology Center of Connecticut, Hamden, CT, USA.

Division of Gastroenterology, Yale University School of Medicine, New Haven, CT, USA.

出版信息

SAGE Open Med. 2021 Jan 14;9:2050312120986733. doi: 10.1177/2050312120986733. eCollection 2021.

Abstract

OBJECTIVE

infection and recurrent infection result in substantial economic burden and healthcare resource use. Sepsis and bowel surgery are known to be serious complications of infection. This study evaluated clinical complications in patients with infection and recurrent infection during a 12-month period following the primary infection.

METHODS

A retrospective analysis of commercial claims data from the IQVIA PharMetrics Plus™ database was conducted for patients aged 18-64 years with an index infection episode requiring inpatient stay or an outpatient visit for infection followed by a infection treatment. Each infection episode ended after a 14-day infection-claim-free period was observed. Recurrent infection was defined as a further infection episode within an 8-week window following the claim-free period. Clinical complications were documented over 12 months of follow-up and stratified by the number of recurrent infection episodes (0 rCDI, 1 rCDI, 2 rCDI, and 3+ rCDI).

RESULTS

In total, 46,571 patients with index infection episode were included. During the 6-month pre-index, the mean (standard deviation) baseline Charlson comorbidity index score, by increasing the recurrent infection group, was 1.2 (1.9), 1.5 (2.2), 1.8 (2.3), and 2.3 (2.5). During the 12-month follow-up, sepsis occurred in 16.5%, 27.3%, 33.1%, and 43.3% of patients, and subtotal colectomy or diverting loop ileostomy was performed in 4.6%, 7.3%, 8.9%, and 10.5% of patients, respectively, by increasing the recurrent infection group.

CONCLUSIONS

Reduction in recurrent infection is an important step to reduce the burden of serious clinical complications, and new treatments are needed to reduce infection recurrence.

摘要

目的

感染及反复感染会导致巨大的经济负担和医疗资源消耗。脓毒症和肠道手术是已知的感染严重并发症。本研究评估了初次感染后12个月内感染及反复感染患者的临床并发症情况。

方法

对IQVIA PharMetrics Plus™数据库中18 - 64岁因初次感染发作需住院或门诊就诊且随后接受感染治疗的患者的商业索赔数据进行回顾性分析。每个感染发作在观察到14天无感染索赔期后结束。反复感染定义为在无索赔期后的8周内再次出现感染发作。在12个月的随访期间记录临床并发症,并按反复感染发作次数(0次反复艰难梭菌感染、1次反复艰难梭菌感染、2次反复艰难梭菌感染和3次及以上反复艰难梭菌感染)进行分层。

结果

总共纳入了46,571例初次感染发作的患者。在索引前6个月,随着反复感染组的增加,平均(标准差)基线查尔森合并症指数评分分别为1.(1.9)、1.5(2.2)、1.8(2.3)和2.3(2.5)。在12个月的随访期间,随着反复感染组的增加,分别有16.5%、27.3%、33.1%和43.3%的患者发生脓毒症,分别有4.6%、7.3%、8.9%和10.5%的患者接受了次全结肠切除术或转流性回肠造口术。

结论

减少反复感染是减轻严重临床并发症负担的重要一步,需要新的治疗方法来减少感染复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fa5/7812403/6158519b6158/10.1177_2050312120986733-fig1.jpg

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