肺移植后的肺部细菌感染:风险因素和对短期死亡率的影响
Rong Gao1, Wenjing Wang2, Ting Qian3
1Department of Laboratory Medicine, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu 214023, China.
The Journal of infection
|September 15, 2024
概括
肺移植 (LTX) 后的肺细菌感染 (PBI) 是常见的,并且与死亡率的增加有关. 早期PBI (7天内) 显著影响生存率,突出显示了迅速干预的必要性.
科学领域:
- 移植免疫学 移植免疫学
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
背景情况:
- 肺部细菌感染 (PBI) 是肺移植 (LTX) 后的一个严重并发症.
- 识别风险因素和了解PBI对患者结果的影响对于改善移植后护理至关重要.
研究的目的:
- 调查LTX后与PBI相关的风险因素.
- 评估PBI对LTX接受者的短期术后死亡率的影响.
主要方法:
- 从2018年1月到2021年12月,对549名LTX受益人的回顾性分析.
- 单变量和多变量物流回归以确定PBI风险因素.
- 考克斯比例危险回归以评估死亡率,根据PBI时间 (≤7天而不是8-30天) 进行子组分析.
主要成果:
- 手术后PBI的发生率为82.70%.
- 风险因素包括手术前多药耐药细菌感染史,捐赠者Acinetobacter baumannii感染,以及更长的感冒缺血时间.
- PBI与增加的一年,两年和三年死亡率有关. 早期PBI (≤7天) 显著影响了死亡率,而8-30天的PBI没有显示出显著的关联.
结论:
- 捐赠者-接受者因素和手术变量是LTX后PBI的关键风险因素.
- 在LTX后的第一周内,积极预防和管理PBI对于提高患者短期存活率至关重要.
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