Ying Piaopiao, Chen Jiajing, Ye Yinchai, Xu Chang, Ye Jianzhong
Department of General Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, People's Republic of China.
Department of Nephrology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou, People's Republic of China.
Infect Drug Resist. 2024 Oct 29;17:4741-4752. doi: 10.2147/IDR.S479302. eCollection 2024.
This study aimed to investigate the correlation between computed tomography (CT) derived body composition and 30-day mortality in patients with pulmonary infections caused by carbapenem-resistant ().
A total of 89 eligible participants from a tertiary teaching hospital, enrolled between January 1, 2016, and December 31, 2020, were included in the study. We analyzed the relationship between visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), and skeletal muscle (SM) and 30-day mortality in patients infected with carbapenem-resistant (CRKP) in the pulmonary region. Furthermore, we established Cox regression models and a personalized nomogram model to predict the probability of 30-day mortality in these infected patients.
Individuals with high VAT exhibited a higher likelihood of 30-day all-cause mortality (P<0.01) and 30-day mortality due to CRKP infection (P<0.01) compared to those with low VAT. Similar results were observed for TAT. After adjusting for significant comorbidities and other clinical characteristics, Cox regression analysis revealed that male gender (adjusted HR = 4.37; 95% CI = 0.96-19.92, P=0.06), vasopressor use (adjusted HR = 3.65; 95% CI = 1.04-12.85, P=0.04), and VAT (adjusted HR = 1.16; 95% CI = 1.01-1.34, P=0.03) were independent risk factors for 30-day all-cause mortality among these infectious patients.
The study results highlight the significant prognostic value of CT-quantified visceral adipose tissue in patients with CRKP pulmonary infection. Individuals with high VAT are more prone to mortality within 30 days compared to those with low VAT.
本研究旨在探讨计算机断层扫描（CT）得出的身体成分与耐碳青霉烯类[病原体未提及]所致肺部感染患者30天死亡率之间的相关性。
本研究纳入了2016年1月1日至2020年12月31日期间在一家三级教学医院招募的89名符合条件的参与者。我们分析了肺部耐碳青霉烯类[病原体未提及]（CRKP）感染患者的内脏脂肪组织（VAT）、皮下脂肪组织（SAT）、总脂肪组织（TAT）和骨骼肌（SM）与30天死亡率之间的关系。此外，我们建立了Cox回归模型和个性化列线图模型，以预测这些感染患者30天死亡率的概率。
与低VAT患者相比，高VAT患者30天全因死亡率（P<0.01）和CRKP感染所致30天死亡率（P<0.01）的可能性更高。TAT也观察到类似结果。在调整了显著的合并症和其他临床特征后，Cox回归分析显示，男性（调整后HR = 4.37；95%CI = 0.96 - 19.92，P = 0.06）、血管活性药物使用（调整后HR = 3.65；95%CI = 1.04 - 12.85，P = 0.04）和VAT（调整后HR = 1.16；95%CI = 1.01 - 1.34，P = 0.03）是这些感染患者30天全因死亡率的独立危险因素。
研究结果突出了CT定量内脏脂肪组织在CRKP肺部感染患者中的显著预后价值。与低VAT患者相比，高VAT患者在30天内更易死亡。
