Turner B J, Denison M, Eppes S C, Houchens R, Fanning T, Markson L E
Center for Research in Medical Education and Health Care, Jefferson Medical College.
Pediatr Infect Dis J. 1993 Apr;12(4):310-20. doi: 10.1097/00006454-199304000-00010.
To define predictors of survival we studied longitudinal histories of 789 New York State Medicaid-enrolled children diagnosed with acquired immunodeficiency syndrome (AIDS) from 1983 to 1989 and followed through 1990. Median survival times for 3 severity groups of AIDS-defining conditions were 66, 48 and 9 months. In a proportional hazards model, the relative risk of death for the most vs. least severe group was 3.33 (95% confidence interval, 2.53, 4.37) and the relative risk for children < 6 months old at diagnosis vs. older children was 1.81 (95% confidence interval, 1.41, 2.34). We increased our ability to predict death by using a 4-category severity index that assesses both the AIDS-defining diagnosis and clinical complications within 3 months of diagnosis (relative risk, 5.27; 95% confidence interval, 3.16, 8.78 for most vs. least severe). These analyses offer new clinical severity measures and reveal that, regardless of the AIDS-defining diagnosis, children with AIDS who are < 6 months old have a poor prognosis.
为了确定生存的预测因素，我们研究了1983年至1989年期间纽约州医疗补助计划登记的789名被诊断为获得性免疫缺陷综合征（AIDS）的儿童的纵向病史，并随访至1990年。定义AIDS的3个严重程度组的中位生存时间分别为66、48和9个月。在比例风险模型中，最严重组与最不严重组的死亡相对风险为3.33（95%置信区间为2.53至4.37），诊断时年龄<6个月的儿童与年龄较大儿童的死亡相对风险为1.81（95%置信区间为1.41至2.34）。我们通过使用一个4类严重程度指数提高了预测死亡的能力，该指数评估定义AIDS的诊断和诊断后3个月内的临床并发症（最严重组与最不严重组的相对风险为5.27；95%置信区间为3.16至8.78）。这些分析提供了新的临床严重程度测量方法，并表明，无论定义AIDS的诊断如何，诊断时年龄<6个月的AIDS儿童预后较差。
