Solera J, Martínez-Alfaro E, Espinosa A, Castillejos M L, Geijo P, Rodríguez-Zapata M
Department of Medicine, Unit of Infectious Diseases, Hospital of Albacete, Spain.
J Infect. 1998 Jan;36(1):85-92. doi: 10.1016/s0163-4453(98)93342-4.
Demographic, clinical, and laboratory data from 200 consecutive patients with acute brucellosis were analysed with univariate and multivariate methods to identify correlates of relapse. A risk score for predicting relapse was then calculated by using Cox proportional hazard model. The independent predictors of relapse were temperature of 38.3 degrees C or higher, positive blood cultures at baseline, and the duration of symptoms before treatment <10 days. Stratification according to the risk score demonstrated that rates of relapse were significantly different between risk groups (P<0.0001). The low-risk group had a 4.5% probability (6 of 135) of relapse at 12 months. In contrast, relapse was present in 15 of 47 patients in the medium-risk group (P<0.0017); and in 12 of 18 patients in the high-risk group (P<0.0001). This study provides a rational basis for estimating the risk of relapse in patients with acute brucellosis, and may be helpful in deciding what subjects might benefit from extra attention.
采用单因素和多因素方法对200例急性布鲁氏菌病患者的人口统计学、临床和实验室数据进行分析，以确定复发的相关因素。然后使用Cox比例风险模型计算预测复发的风险评分。复发的独立预测因素为体温38.3℃或更高、基线血培养阳性以及治疗前症状持续时间<10天。根据风险评分进行分层显示，风险组之间的复发率有显著差异（P<0.0001）。低风险组在12个月时复发概率为4.5%（135例中有6例）。相比之下，中风险组47例患者中有15例复发（P<0.0017）；高风险组18例患者中有12例复发（P<0.0001）。本研究为评估急性布鲁氏菌病患者的复发风险提供了合理依据，可能有助于确定哪些患者可能从额外关注中获益。
