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严重肝损伤影响儿童社区获得性肺炎的结局和住院时间。

Severe liver injury affects the outcomes and length of hospital stay in children with community-acquired pneumonia.

机构信息

Division of Neonatology, Department of Pediatrics, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Sichuan Clinical Research Center for Birth Defects.

出版信息

Afr Health Sci. 2022 Sep;22(3):578-589. doi: 10.4314/ahs.v22i3.62.

Abstract

BACKGROUND

The present study was undertaken to evaluate the association between liver injury and clinical parameters, outcomes and length of stay (LOS) in hospital in children with community-acquired pneumonia (CAP).

METHODS

Clinical data and laboratory indicators of 2,573 children with CAP were analyzed. The association between liver injury and clinical parameters, outcomes and LOS was then analyzed.

RESULTS

Higher liver injury class was associated with higher incidence of severe CAP, comorbidities, hypoxia, requirement for mechanical ventilation, 30-day mortality and intensive care unit admission, and higher indicators of inflammation (C-reactive protein, procalcitonin and white blood cell count), longer LOS, faster respiratory rate and pulse rate, and lower age, serum albumin levels, monocyte and lymphocyte counts. Severe liver injury was identified as an independent factor for 30-day mortality and prolonged LOS in children with CAP. Higher liver injury class was associated with a lower cumulative survival rate (p=0.0004), and log-rank test for trend was used to demonstrate the association of each injury class with 30-day mortality (p=0.0002).

CONCLUSIONS

Several parameters were associated with liver injury in children with CAP. Severe liver injury was found to be an independent factor for 30-day mortality and LOS in children with CAP.

摘要

背景

本研究旨在评估儿童社区获得性肺炎(CAP)中肝损伤与临床参数、结局和住院时间(LOS)的关系。

方法

分析了 2573 例 CAP 患儿的临床资料和实验室指标,分析了肝损伤与临床参数、结局和 LOS 的关系。

结果

较高的肝损伤分级与重症 CAP、合并症、缺氧、需要机械通气、30 天死亡率和入住重症监护病房的发生率较高,炎症指标(C 反应蛋白、降钙素原和白细胞计数)较高,LOS 较长,呼吸和脉搏较快,年龄、血清白蛋白水平、单核细胞和淋巴细胞计数较低有关。严重肝损伤是 CAP 患儿 30 天死亡率和 LOS 延长的独立因素。较高的肝损伤分级与累积生存率较低有关(p=0.0004),趋势检验对数秩检验表明,各损伤分级与 30 天死亡率相关(p=0.0002)。

结论

CAP 患儿的几个参数与肝损伤有关。严重肝损伤是 CAP 患儿 30 天死亡率和 LOS 延长的独立因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e65e/9993292/85f383359e6d/AFHS2203-0578Fig1.jpg

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