Emerg Infect Dis. 2022 Aug;28(8):1615-1623. doi: 10.3201/eid2808.212469.
The relationship between increased short-term mortality rates after invasive pneumococcal disease (IPD) has been frequently studied. However, the relationship between IPD and long-term mortality rates is unknown. IPD patients in Alberta, Canada, had clinical data collected that were linked to administrative databases. We used Cox proportional hazards modeling, and the primary outcome was time to all-cause deaths. First IPD events were identified in 4,522 patients, who had a median follow-up of 3.2 years (interquartile range 0.8‒9.1 years). Overall all-cause mortality rates were consistently higher among cases than controls at 30 days (adjusted hazard ratio [aHR] 3.75, 95% CI 3.29-4.28), 30‒90 days (aHR 1.56, 95% CI 1.27‒1.93), and >90 days (aHR 1.43, 95% CI 1.33-1.54). IPD increases risk for short, intermediate, and long-term mortality rates regardless of age, sex, or concurrent conditions. These findings can help clinicians focus on postdischarge patient plans to limit long-term effects after acute IPD infection.
侵袭性肺炎球菌病（IPD）后短期死亡率增加的关系已被频繁研究。然而，IPD 与长期死亡率之间的关系尚不清楚。加拿大艾伯塔省的 IPD 患者的临床数据被收集并与行政数据库相关联。我们使用 Cox 比例风险模型，主要结局是全因死亡的时间。在 4522 名患者中确定了首次 IPD 事件，中位随访时间为 3.2 年（四分位距 0.8-9.1 年）。在 30 天（调整后的危险比 [aHR] 3.75，95%置信区间 [CI] 3.29-4.28）、30-90 天（aHR 1.56，95% CI 1.27-1.93）和 >90 天（aHR 1.43，95% CI 1.33-1.54）时，病例的全因死亡率始终高于对照组。无论年龄、性别或并存疾病如何，IPD 都会增加短期、中期和长期死亡率的风险。这些发现可以帮助临床医生关注出院后患者的计划，以限制急性 IPD 感染后的长期影响。
