基于2016年至2021年的患者记录数据,确定复发多药耐药结核病的危险因素:回顾性研究
Teramaj Wongel Wotale1,2, Mesfin Esayas Lelisho3, Bikiltu Wakuma Negasa4
1Department of Statistics, College of Natural and Computational Sciences, Dilla University, Dilla, Ethiopia. teramaj24@gmail.com.
Scientific reports
|October 13, 2024
概括
多药耐药结核病 (MDR-TB) 的复发受到各种因素的影响. 体重较低,吸烟,饮酒和某些临床条件增加了复发风险,而高等教育和年龄可能会推迟复发.
科学领域:
- 流行病学 流行病学
- 生物统计学 生物统计学
- 公共卫生 公共卫生
背景情况:
- 全球多耐药结核病 (MDR-TB) 病例的增加,由于治疗难度和治疗结果较差,造成了重大的公共卫生挑战.
- 了解MDR-TB复发的风险因素对于改善患者管理和控制策略至关重要.
研究的目的:
- 确定与多抗药结核病 (MDR-TB) 在埃塞俄比亚亚的斯亚贝巴Alert专科医院治疗的患者中复发相关的风险因素.
- 应用参数共享脆弱性模型来分析MDR-TB的时间到复发数据.
主要方法:
- 从2016年1月到2021年12月进行了一项回顾性研究,分析了MDR-TB患者的医疗记录.
- 采用了参数共享脆弱性模型,包括Gamma和反向高斯模型,具有指数级,韦布尔和逻辑正常基线危险.
- 使用R统计软件进行数据分析,以评估复发预测因素和集群效应.
主要成果:
- 到MDR-TB复发的中位时间为12个月,34.3%的患者复发.
- 在医院的MDR-TB患者中观察到显著的集群效应.
- 韦布尔-反向-高斯斯共享脆弱模型确定了体重较低,吸烟,饮酒,血,肺炎,先前的抗结核治疗,农村居住和糖尿病作为加速复发的因素. 高等教育和年龄与延迟复发有关.
结论:
- 体重较低,吸烟,饮酒,血,肺炎,先前的抗结核治疗,农村居住和糖尿病等因素是MDR-TB复发的显著预后因素.
- 高等教育和年龄的增加似乎是保护因素,延长了复发的时间.
- 韦布尔-逆高斯共享脆弱性模型对预测MDR-TB复发时间是有效的,强调了在临床实践中解决已确定的风险因素的重要性.
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