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哥伦比亚社区获得性肺炎患者3个月、6个月和12个月的生存率:一项回顾性队列研究。

Survival at 3, 6 and 12 months in patients diagnosed with community-acquired pneumonia in Colombia: a retrospective cohort study.

作者信息

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

机构信息

Universidad de La Sabana, School of Medicine, Chía, Colombia.

Universidad de La Sabana, School of Medicine, Chía, Colombia.

出版信息

Braz J Infect Dis. 2024 Jul-Aug;28(4):103852. doi: 10.1016/j.bjid.2024.103852. Epub 2024 Jul 20.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c27f/11327535/4acc75b5af36/gr1.jpg

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