Cui Kunping, Mao Yi, Feng Shuang, Luo Haixia, Yang Jiao, Xu Ruyi, Bai Lang
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
Intensive Care Unit, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, 610000, People's Republic of China.
Infect Drug Resist. 2024 May 10;17:1879-1892. doi: 10.2147/IDR.S455108. eCollection 2024.
Age is considered a vital factor in intensive care units (ICUs) because of its association with physiological frailty, comorbidities, and immune system function. Previous studies have examined the association between age and prognosis in patients with tuberculosis (TB) or sepsis; however, the association between age and prognosis in ICU patients with TB complicated by sepsis is rare. This study aimed to assess the association between age and the prognosis of patients in the ICU with TB complicated by sepsis.
Data from the ICU of the Public Health Clinical Center of Chengdu were analyzed using the multivariable Cox regression model, stratified analysis with interaction, restricted cubic spline (RCS), and threshold effect analysis to investigate the association between age and 28-day all-cause mortality in patients with TB complicated by sepsis.
In total, 520 patients diagnosed with TB and sepsis were enrolled (120 women [23.1%]; median age, 64 years). The association between age and risk of death exhibited a J-shaped curve on the RCS ( for nonlinearity = 0.001). In the threshold analysis, the hazard ratio for the risk of death was 1.104 (95% confidence interval, 1.05-1.16) in participants aged ≥66.2 years. The risk of death increased by 10.4% with every 1-year increase in age in patients with TB complicated by sepsis. No significant association was found between age and 28-day all-cause mortality in patients aged <66.2 years.
A nonlinear relationship was observed between age and short-term all-cause mortality in patients in the ICU with TB complicated by sepsis. Patients with a higher age at admission may have a higher risk of death and require focused attention, close monitoring, and early treatment to reduce mortality.
由于年龄与生理脆弱性、合并症及免疫系统功能相关，其被视为重症监护病房（ICU）中的一个重要因素。既往研究已探讨年龄与肺结核（TB）或脓毒症患者预后之间的关联；然而，关于合并脓毒症的ICU肺结核患者年龄与预后之间的关联却鲜有研究。本研究旨在评估合并脓毒症的ICU肺结核患者年龄与预后之间的关联。
采用多变量Cox回归模型、交互作用分层分析、限制性立方样条（RCS）及阈值效应分析，对成都公共卫生临床中心ICU的数据进行分析，以研究合并脓毒症的肺结核患者年龄与28天全因死亡率之间的关联。
共纳入520例诊断为肺结核合并脓毒症的患者（120例女性[23.1%]；中位年龄64岁）。RCS显示年龄与死亡风险之间呈J形曲线（非线性检验P = 0.001）。在阈值分析中，年龄≥66.2岁参与者的死亡风险的风险比为1.104（95%置信区间，1.05 - 1.16）。合并脓毒症的肺结核患者年龄每增加1岁，死亡风险增加10.4%。年龄<66.2岁的患者中，未发现年龄与28天全因死亡率之间存在显著关联。
在合并脓毒症的ICU肺结核患者中，观察到年龄与短期全因死亡率之间存在非线性关系。入院时年龄较大的患者可能死亡风险更高，需要重点关注、密切监测及早期治疗以降低死亡率。
