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肺炎相关重症监护病房住院与痴呆症关联的真实世界证据

Real-World Evidence for the Association Between Pneumonia-Related Intensive Care Unit Stay and Dementia.

作者信息

Wu Chun-Han, Peng Chung-Kan, Chung Chi-Hsian, Chien Wu-Chien, Tzeng Nian-Sheng

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.

Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Psychiatry Investig. 2022 Apr;19(4):247-258. doi: 10.30773/pi.2021.0277. Epub 2022 Apr 22.

Abstract

OBJECTIVE

There is limited clarity concerning the risk of dementia after pneumonia with intensive care unit (ICU) stay. We conducted a nationwide cohort study, which aimed to investigate the impact of dementia after pneumonia with and without intensive care unit admission.

METHODS

Data was obtained from Taiwan's National Health Insurance Research Database between 2000 and 2015. A total of 7,473 patients were identified as having pneumonia required ICU stay, along with 22,419 controls matched by sex and age. After adjusting for confounding factors, multivariate Cox regression model analysis was used to compare the risk of developing dementia during the 15-years follow-up period.

RESULTS

The enrolled pneumonia patients with ICU admission had a dementia rate of 9.89%. Pneumonia patients without ICU admission had a dementia rate of 9.21%. The multivariate Cox regression model analysis revealed that the patients with ICU stay had the higher risk of dementia, with a crude hazard ratio of 3.371 (95% confidence interval, 3.093-3.675; p<0.001).

CONCLUSION

This study indicated that pneumonia with ICU stay is associated with an increased risk of dementia. A 3-fold risk of dementia was observed in patients admitted to the ICU compared to the control group.

摘要

目的

关于入住重症监护病房(ICU)的肺炎患者发生痴呆症的风险,目前尚不清楚。我们开展了一项全国性队列研究,旨在调查入住和未入住ICU的肺炎患者发生痴呆症的影响。

方法

数据来自2000年至2015年台湾地区国民健康保险研究数据库。共确定7473例需要入住ICU的肺炎患者,以及22419例按性别和年龄匹配的对照。在调整混杂因素后,采用多变量Cox回归模型分析比较15年随访期内发生痴呆症的风险。

结果

纳入的入住ICU的肺炎患者痴呆症发生率为9.89%。未入住ICU的肺炎患者痴呆症发生率为9.21%。多变量Cox回归模型分析显示,入住ICU的患者发生痴呆症的风险更高,粗风险比为3.371(95%置信区间为3.093 - 3.675;p<0.001)。

结论

本研究表明,入住ICU的肺炎患者发生痴呆症的风险增加。与对照组相比,入住ICU的患者发生痴呆症的风险为3倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1a/9058270/63663726ab3f/pi-2021-0277f1.jpg

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