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2003-2014 年美国国家住院患者样本数据库中疾病流行率、死亡率、严重程度和年龄构成的趋势。

Trends in prevalence, mortality, severity, and age composition during 2003-2014, the national inpatient sample database in the US.

机构信息

Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.

Department of Medicine, New York Presbyterian, Queens, NY, USA.

出版信息

Ann Med. 2022 Dec;54(1):1851-1858. doi: 10.1080/07853890.2022.2092893.

Abstract

BACKGROUND

(formerly known as ) infection (CDI) is one of the most prevalent healthcare-associated infections in the United States (US). In the early 2000s, CDI emerged as a great threat with increasing prevalence, mortality, and severity, especially in advanced age. We investigated the US national trends in in-hospital CDI prevalence, mortality, severity, and age composition from 2003 to 2014.

METHODS

We identified the patients with CDI using the national inpatient sample data from 2003 to 2014. We performed Poisson regression model and Kendall's tau-b correlation test for our analyses.

RESULTS

Adjusted overall CDI prevalence did not significantly change during 2003-2014. In-hospital mortality of overall CDI did not significantly change during 2003-2008, then significantly decreased during 2008-2014. Severity of overall CDI significantly increased during 2003-2008, then decreased during 2008-2014. The proportions of patients with age 65 years decreased in CDI prevalence, mortality, and severity during 2003-2014.

CONCLUSIONS

Compared to the earlier years 2003-2008, overall CDI outcome improved in the later years 2008-2014. Younger patients increasingly contributed to CDI prevalence, mortality, and severity during 2003-2014. More studies to understand underlying driving forces of changes in CDI trends are warranted to mitigate CDI.

摘要

背景

(以前称为)感染(CDI)是美国(美国)最常见的与医疗保健相关的感染之一。在 21 世纪初,CDI 随着发病率、死亡率和严重程度的不断增加,尤其是在老年人中,成为一个巨大的威胁。我们调查了 2003 年至 2014 年美国住院患者 CDI 发病率、死亡率、严重程度和年龄构成的全国趋势。

方法

我们使用 2003 年至 2014 年全国住院患者样本数据确定了 CDI 患者。我们进行了泊松回归模型和肯德尔 tau-b 相关检验分析。

结果

2003-2014 年,调整后的总体 CDI 发病率没有显著变化。2003-2008 年,总体 CDI 的院内死亡率没有显著变化,然后在 2008-2014 年显著下降。2003-2008 年,总体 CDI 的严重程度显著增加,然后在 2008-2014 年下降。2003-2014 年,年龄 65 岁的患者在 CDI 发病率、死亡率和严重程度中的比例下降。

结论

与 2003-2008 年早些年相比,2008-2014 年后期总体 CDI 预后有所改善。在 2003-2014 年期间,年轻患者越来越多地导致 CDI 的发病率、死亡率和严重程度增加。需要更多的研究来了解 CDI 趋势变化的潜在驱动因素,以减轻 CDI 的影响。

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