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艾滋病合并呼吸衰竭患者的肺部感染及预后:一项10年回顾性研究

Pulmonary Infections and Outcomes in AIDS Patients with Respiratory Failure: A 10-Year Retrospective Review.

作者信息

Hao Jingjing, Liu Jingyuan, Pu Lin, Li Chuansheng, Yin Ningning, Li Ang

机构信息

Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Feb 20;16:1049-1059. doi: 10.2147/IDR.S395658. eCollection 2023.

Abstract

BACKGROUND

Respiratory failure in acquired immunodeficiency syndrome (AIDS) patients was the leading cause of intensive care unit (ICU) admission in our center. We aimed to describe the pulmonary infections and outcomes for respiratory failure in AIDS patients.

METHODS

A retrospective study was conducted on AIDS adult patients with respiratory failure who were admitted to the ICU in Beijing Ditan hospital, China, from January 2012 to December 2021. We investigated pulmonary infections complicated by respiratory failure in AIDS patients. The primary outcome was ICU mortality, and a comparison between survivors and nonsurvivors was performed. Multiple logistic regression analysis was used to identify predictors of ICU mortality. The Kaplan-Meier curve and Log rank test were used for survival analysis.

RESULTS

A total of 231 AIDS patients were admitted to ICU with respiratory failure over a 10-year period with a male predominance (95.7%). pneumonia was the main etiology of pulmonary infections (80.1%). The ICU mortality was 32.9%. In multivariate analysis, ICU mortality was independently associated with invasive mechanical ventilation (IMV) [odds ratio (OR), 27.910; 95% confidence interval (CI, 8.392-92.818; = 0.000) and the time before ICU admission (OR, 0.959; 95% CI, 0.920-0.999; = 0.046). In the survival analysis, patients with IMV and later admission to ICU had a higher probability of mortality.

CONCLUSION

pneumonia was the primary etiology for respiratory failure in AIDS patients admitted to the ICU. Respiratory failure remains a severe illness with high mortality, and ICU mortality was negatively associated with IMV and later admission to ICU.

摘要

背景

获得性免疫缺陷综合征(AIDS)患者的呼吸衰竭是我们中心重症监护病房(ICU)收治患者的主要原因。我们旨在描述AIDS患者呼吸衰竭的肺部感染情况及预后。

方法

对2012年1月至2021年12月在中国北京地坛医院ICU收治的成年AIDS呼吸衰竭患者进行回顾性研究。我们调查了AIDS患者并发呼吸衰竭的肺部感染情况。主要结局是ICU死亡率,并对幸存者和非幸存者进行了比较。采用多因素逻辑回归分析确定ICU死亡率的预测因素。采用Kaplan-Meier曲线和Log rank检验进行生存分析。

结果

在10年期间,共有231例AIDS呼吸衰竭患者入住ICU,以男性为主(95.7%)。肺炎是肺部感染的主要病因(80.1%)。ICU死亡率为32.9%。多因素分析显示,ICU死亡率与有创机械通气(IMV)独立相关[比值比(OR)为27.910;95%置信区间(CI)为8.392 - 92.818;P = 0.000]以及入住ICU前的时间(OR为0.959;95% CI为0.920 - 0.999;P = 0.046)。在生存分析中,接受IMV且较晚入住ICU的患者死亡概率更高。

结论

肺炎是入住ICU的AIDS患者呼吸衰竭的主要病因。呼吸衰竭仍然是一种严重疾病,死亡率高,且ICU死亡率与IMV及较晚入住ICU呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fda7/9951600/34d3a3951b13/IDR-16-1049-g0001.jpg

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