韩国脑脓肿患者不良临床结局的危险因素。
Risk factors for unfavorable clinical outcomes in patients with brain abscess in South Korea.
机构信息
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
出版信息
PLoS One. 2021 Sep 20;16(9):e0257541. doi: 10.1371/journal.pone.0257541. eCollection 2021.
BACKGROUND
Brain abscess can be life-threatening and manifest various neurological findings, although the mortality rate has decreased recently. We investigated the risk factors for unfavorable outcomes of patients with brain abscess.
METHODS
A retrospective cohort study examined patients with brain abscess seen from May 2005 to December 2018 in a tertiary care hospital in Seoul, South Korea. We reviewed the medical records for clinical findings, therapeutic modalities, and prognostic factors of brain abscess. Unfavorable clinical outcomes were defined as death, moderate to severe disability with neurological deficits, or vegetative state at 1 year or at the time of discharge from outpatient follow-up.
RESULTS
The study enrolled 135 patients: 65.2% were males; the mean age was 56 years. 35.6% had unfavorable outcomes. In multivariate analysis, higher Sequential Organ Failure Assessment (SOFA) (p < 0.001), pre-existing hemiplegia (p = 0.049), and higher Charlson comorbidity index (CCI) (p = 0.028) were independently associated with unfavorable outcomes.
CONCLUSIONS
Higher SOFA, pre-existing hemiplegia and higher Charlson comorbidity index were significant risk factors for unfavorable clinical outcomes in patients with brain abscess.
背景
脑脓肿可能危及生命，并表现出各种神经学发现，尽管死亡率最近有所下降。我们研究了脑脓肿患者不良预后的危险因素。
方法
本回顾性队列研究调查了韩国首尔一家三级保健医院 2005 年 5 月至 2018 年 12 月期间收治的脑脓肿患者。我们查阅了病历，以了解脑脓肿的临床特征、治疗方式和预后因素。不良临床结局定义为 1 年内死亡、存在中度至重度残疾伴神经功能缺损，或植物状态，或在门诊随访期间出院。
结果
本研究纳入了 135 名患者：65.2%为男性；平均年龄为 56 岁。35.6%的患者预后不良。多变量分析显示，较高的序贯器官衰竭评估（SOFA）（p<0.001）、预先存在的偏瘫（p=0.049）和较高的 Charlson 合并症指数（CCI）（p=0.028）与不良结局独立相关。
结论
较高的 SOFA、预先存在的偏瘫和较高的 Charlson 合并症指数是脑脓肿患者不良临床结局的显著危险因素。
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