埃利克豪泽合并症方法预测西班牙无脾症和肺炎球菌性肺炎住院患者的死亡。

Elixhauser comorbidity method in predicting death of Spanish inpatients with asplenia and pneumococcal pneumonia.

机构信息

Faculty of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador.

Department of Medical Specialties and Public Health, Rey Juan Carlos University, Madrid, Spain.

出版信息

BMC Infect Dis. 2024 Jun 20;24(1):607. doi: 10.1186/s12879-024-09517-4.

DOI:10.1186/s12879-024-09517-4

PMID:38902621

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11188201/

Abstract

BACKGROUND

Pneumococcal pneumonia (PP) is a serious infection caused by Streptococcus pneumoniae (pneumococcus), with a wide spectrum of clinical manifestations. The aim of this study was to analyze the comorbidity factors that influenced the mortality in patients with asplenia according to PP.

METHODS

Discharge reports from the Spanish Minimum Basic Data Set (MBDS) was used to retrospectively analyze patients with asplenia and PP, from 1997 to 2021. Elixhauser Comorbidity Index (ECI) was calculated to predict in-hospital mortality (IHM).

RESULTS

97,922 patients with asplenia were included and 381 cases of PP were identified. The average age for men was 63.87 years and for women 65.99 years. In all years, ECI was larger for splenectomized than for non-splenectomized patients, with men having a higher mean ECI than women. An association was found between risk factors ECI, splenectomy, age group, sex, pneumococcal pneumonia, and increased mortality (OR = 0.98; 95% CI: 0.97-0.99; p < 0.001). The IHM increased steadily with the number of comorbidities and index scores in 1997-2021.

CONCLUSIONS

Asplenia remain a relevant cause of hospitalization in Spain. Comorbidities reflected a great impact in patients with asplenia and PP, which would mean higher risk of mortality.

摘要

背景

肺炎球菌性肺炎（PP）是由肺炎链球菌（肺炎球菌）引起的严重感染，临床表现广泛。本研究旨在根据 PP 分析影响无脾患者死亡率的合并症因素。

方法

使用西班牙最低基本数据集（MBDS）的出院报告，回顾性分析了 1997 年至 2021 年期间患有脾切除和肺炎球菌性肺炎的患者。计算了 Elixhauser 合并症指数（ECI）以预测住院死亡率（IHM）。

结果

共纳入 97922 例脾切除患者，其中 381 例为肺炎球菌性肺炎。男性的平均年龄为 63.87 岁，女性为 65.99 岁。在所有年份中，脾切除患者的 ECI 均大于非脾切除患者，男性的平均 ECI 高于女性。发现危险因素 ECI、脾切除术、年龄组、性别、肺炎球菌性肺炎与死亡率增加之间存在关联（OR=0.98；95%CI：0.97-0.99；p<0.001）。1997 年至 2021 年，IHM 随着合并症数量和指数评分的增加而稳步上升。