患有和没有艾滋病毒感染的患者中败血症的结果:一项回顾性研究
1Kevin Gray is a resident physician, Department of Anesthesiology, The Ohio State University, Columbus, Ohio.
概括
艾滋病毒感染并没有增加败血症死亡率. 研究人员在感染艾滋病毒和没有感染艾滋病毒的败血症患者中发现了相似的生存率,将肥胖和高蛋白质确定为降低死亡率的因素.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 公共卫生 公共卫生
背景情况:
- 众所周知,艾滋病毒感染会增加对各种感染的易感性.
- 了解艾滋病毒对败血症等严重感染的影响对于患者管理至关重要.
研究的目的:
- 为了比较艾滋病毒感染和没有感染的患者的败血症结果.
- 为了确定艾滋病毒是否与败血症患者的死亡率独立相关.
- 确定影响HIV感染性败血症患者死亡率的因素.
主要方法:
- 使用了败血症-3标准来选择患者.
- 通过治疗,诊断或阳性血液测试来确定艾滋病毒感染.
- 雇员倾向性得分匹配用于比较艾滋病毒阳性和艾滋病毒阴性败血症队列.
- 应用后勤回归来确定死亡率预测因素.
主要成果:
- 败血症发生在34673名没有艾滋病毒的患者和326名感染艾滋病毒的患者中.
- 在HIV阳性 (11%,15%,17%) 和HIV阴性 (11%,15%,16%) 败血症患者中,30,60和90天的死亡率是可比的.
- 肥胖和高总蛋白水平与死亡率降低有关.
- 机械呼吸,置换疗法,阳性血液培养和血小板输血与死亡率增加有关.
结论:
- 艾滋病毒感染与败血症患者的死亡率增加无关.
- 肥胖和营养状况等因素显著影响败血症的结果,无论艾滋病毒的状态.
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