影响结核病重症患者死亡率的因素:系统性审查和元分析
Shivangi Mishra1, Jinay Gala2, Jose Chacko2
1Department of Critical Care Medicine, Manipal Hospital Whitefield, Bengaluru, Karnataka, India.
Critical care medicine
|February 12, 2024
概括
鉴定严重肺结核患者死亡率相关的因素对于有针对性的干预措施至关重要. 关键预测因素包括年龄,低血小板和白蛋白水平,高C反应蛋白 (CRP),机械通风和更长的ICU停留时间.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 结核病 (TB) 在重症患者中具有显著的死亡风险.
- 确定影响这些患者结果的特定因素对于改善护理至关重要.
研究的目的:
- 进行元分析,确定与结核病重症患者死亡率相关的因素.
- 为在重症监护室 (ICU) 的高风险结核病患者提供有针对性的治疗策略.
主要方法:
- 在主要数据库 (PubMed,Embase,Cochrane Library,Google Scholar) 中进行了全面的文献搜索.
- 包括的研究比较了重症结核病患者的幸存者和非幸存者之间的死亡因素.
- 在3017个初始记录中,最终的元分析包括了17项研究.
主要成果:
- 确定的主要死亡预测因素包括晚年,血小板数低,低albuminemia,和升高的C反应蛋白 (CRP).
- 侵入性机械通风的需要和持续时间,低PaO2/FiO2比率,急性呼吸困扰综合征 (ARDS) 和休克是重要因素.
- 住院感染,替代疗法和长期住院ICU时间 (LOS) 也与死亡率的增加相关.
结论:
- 患者的年龄,血小板数,白蛋白和CRP水平是死亡风险的关键指标.
- 机械通风参数,呼吸支 (PaO2/FiO2比率),ARDS,休克,感染和支显著影响存活率.
- 集中治疗室停留时间 (LOS) 是关键结核病患者死亡率的一个关键因素.
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