Department of Statistics, Dembi Dolo University, Debretabor University, Ethiopia.
Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Infect Dis. 2023 Oct 12;23(1):682. doi: 10.1186/s12879-023-08646-6.
Pneumonia is the leading infectious cause of mortality worldwide and one of the most common lower respiratory tract infections that is contributing significantly to the burden of antibiotic consumption. The study aims to identify the determinants of the progress of pulse rate, body temperature and time to recovery of pneumonia patients.
A prospective cohort study design was used from Felege Hiwot referral hospital on 214 sampled pneumonia patients from March 01, 2022 up to May 31, 2022. The Kaplan-Meier survival estimate and Log-Rank test was used to compare the survival time. Joint model of bivariate longitudinal and time to event model was used to identify factors of longitudinal change of pulse rate and body temperature with time to recovery jointly.
As the follow up time of pneumonia patient's increase by one hour the average longitudinal change of pulse rate and body temperature were decreased by 0.4236 bpm and 0.0119 [Formula: see text]. The average longitudinal change of pulse rate and body temperature of patients who lived in rural was 1.4602 bpm and 0.1550 [Formula: see text] times less as compared to urban residence. Patients who had dangerous signs are significantly increased the average longitudinal change of pulse rate and body temperature by 2.042 bpm and 0.6031 [Formula: see text] as compared to patients who had no dangerous signs. A patient from rural residence was 1.1336 times more likely to experience the event of recovery as compared to urban residence. The estimated values of the association parameter for pulse rate and body temperature were -0.4236 bpm and -0.0119 respectively, which means pulse rate and body temperature were negatively related with patients recovery time.
Pulse rate and body temperature significantly affect the time to the first recovery of pneumonia patients who are receiving treatment. Age, residence, danger sign, comorbidity, baseline symptom and visiting time were the joint determinant factors for the longitudinal change of pulse rate, body temperature and time to recovery of pneumonia patients. The joint model approach provides precise dynamic predictions, widespread information about the disease transitions, and better knowledge of disease etiology.
肺炎是全球导致死亡的主要传染病病因，也是最常见的下呼吸道感染之一，是导致抗生素消耗负担的主要原因之一。本研究旨在确定肺炎患者脉搏率、体温和恢复时间进展的决定因素。
采用前瞻性队列研究设计，于 2022 年 3 月 1 日至 2022 年 5 月 31 日，从 Felege Hiwot 转诊医院抽取 214 名肺炎患者进行研究。使用 Kaplan-Meier 生存估计和对数秩检验比较生存时间。使用二元纵向联合时间事件模型，联合评估脉搏率和体温的纵向变化与恢复时间的关系。
随着肺炎患者的随访时间增加 1 小时，脉搏率和体温的平均纵向变化分别降低 0.4236 bpm 和 0.0119 [公式：见正文]。与城市居住的患者相比，农村居住的患者的脉搏率和体温的平均纵向变化分别减少 1.4602 bpm 和 0.1550 [公式：见正文]倍。有危险体征的患者的脉搏率和体温的平均纵向变化显著增加 2.042 bpm 和 0.6031 [公式：见正文]倍，与无危险体征的患者相比。与城市居住的患者相比，农村居住的患者发生恢复事件的可能性高 1.1336 倍。脉搏率和体温的关联参数估计值分别为-0.4236 bpm 和-0.0119，这意味着脉搏率和体温与患者的恢复时间呈负相关。
脉搏率和体温显著影响正在接受治疗的肺炎患者首次恢复的时间。年龄、居住地、危险体征、合并症、基线症状和就诊时间是肺炎患者脉搏率、体温和恢复时间纵向变化的共同决定因素。联合模型方法提供了更准确的动态预测、更广泛的疾病转归信息和更好的疾病病因学知识。
