Tuta-Quintero Eduardo, Torres-Arevalo Daniela, Bastidas-Goyes Alirio Rodrigo, Aponte-Murcia Hermencia C, Guerrero Manuela, Giraldo Andrea, Villarraga Laura, Orjuela Laura, Hernández Juan, Giraldo-Cadavid Luis F
Universidad de La Sabana, School of Medicine, Chía, Colombia.
Universidad de La Sabana, School of Medicine, Chía, Colombia.
Braz J Infect Dis. 2024 Jul-Aug;28(4):103852. doi: 10.1016/j.bjid.2024.103852. Epub 2024 Jul 20.
The primary aim of this study is to assess the survival rates of individuals diagnosed with Community-Acquired Pneumonia (CAP) post-hospitalization in Colombia. Additionally, explore potential risk factors associated with decreased long-term survival.
A retrospective cohort study was conducted in a hospital in Colombia, evaluating survival at 3, 6 and 12 months in CAP patients, using the Kaplan-Meier method. Stratifications were made by age, sex, comorbidity, and severity. The comparison of survival curves was performed using the Log-Rank test, a multivariate analysis with Cox regression was performed to study possible risk factors that affected 12-month survival in patients with CAP.
3688 subjects were admitted, with a mortality of 16.3 % per year. Survival at three, six, and twelve months was 92.9 % (95 % CI 92-93 %), 88.8 % (95 % CI 87-90 %), and 84.2 % (95 % CI 82-85 %), respectively. Analysis stratified by pneumonia severity index, 12-month survival was 98.7 % in Class I, 95.6 % in Class II, 87.41 % in Class III, 77.1 % in Class IV, and 65.8 % in class-V (p < 0.001). Cox-regression showed that being male (HR = 1.44; 95 % CI 1.22‒1.70; p < 0.001), an elevated pneumonia severity index (HR = 4.22; 95 % CI 1.89‒9.43; p < 0.001), a high comorbidity index (HR = 2.29; 95 % CI 1.89‒2.84; p < 0.001) and vasopressor requirement (HR = 2.22; 95 % CI < 0.001) were associated with a lower survival at twelve months of follow-up.
Survival in patients with CAP who require hospitalization decreases at 3, 6, and 12 months of follow-up, being lower in patients older than 65 years, men, high comorbidity, and in subjects with severe presentation of the disease.
本研究的主要目的是评估哥伦比亚社区获得性肺炎（CAP）患者出院后的生存率。此外，探索与长期生存率降低相关的潜在风险因素。
在哥伦比亚的一家医院进行了一项回顾性队列研究，采用Kaplan-Meier方法评估CAP患者3个月、6个月和12个月的生存率。按年龄、性别、合并症和严重程度进行分层。使用对数秩检验比较生存曲线，进行多变量Cox回归分析以研究影响CAP患者12个月生存率的可能风险因素。
共纳入3688名受试者，年死亡率为16.3%。3个月、6个月和12个月的生存率分别为92.9%（95%CI 92-93%）、88.8%（95%CI 87-90%）和84.2%（95%CI 82-85%）。根据肺炎严重程度指数分层分析，I级患者12个月生存率为98.7%，II级为95.6%，III级为87.41%，IV级为77.1%，V级为65.8%（p<0.001）。Cox回归显示，男性（HR=1.44；95%CI 1.22‒1.70；p<0.001）、肺炎严重程度指数升高（HR=4.22；95%CI 1.89‒9.43；p<0.001）、高合并症指数（HR=2.29；95%CI 1.89‒2.84；p<0.001）和血管升压药需求（HR=2.22；95%CI<0.001）与随访12个月时较低生存率相关。
需要住院治疗的CAP患者在随访3个月、6个月和12个月时生存率下降，65岁以上患者、男性、合并症高以及疾病表现严重的患者生存率更低。
