将被送往重症监护室的艾滋病毒感染者和没有艾滋病毒感染者的短期死亡率进行比较:单中心匹配队列研究 (2000-2019)
N Bakewell1,2, T Kanitkar3,4, O Dissanayake4
1Institute for Global Health, University College London, London, UK.
HIV medicine
|November 20, 2024
概括
尽管情况有所改善,但被送往重症监护室 (ICU) 的艾滋病毒感染者仍面临比没有艾滋病毒的人更高的短期死亡率. 这项匹配的队列研究强调了对艾滋病毒重症监护结果的持续研究的需要.
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
- 流行病学 流行病学
背景情况:
- 被送往重症监护室 (ICU) 的艾滋病毒 (人类免疫缺陷病毒) 感染者生存率接近没有艾滋病毒的人的生存率.
- 了解ICU设置中的短期死亡率差异对于改善艾滋病毒感染者的护理至关重要.
研究的目的:
- 为了比较2000年至2019年期间接受大型医院ICU治疗的艾滋病毒感染者和没有艾滋病毒感染者的短期死亡率 (在ICU和医院).
- 为了调查艾滋病毒与ICU中的短期死亡率之间的关联在研究期间是否有所变化.
主要方法:
- 采用了一种匹配队列研究设计,将艾滋病毒感染者与没有艾滋病毒感染者匹配为1:2的比例.
- 匹配标准包括年龄,性别,入院年份,以及急性生理和慢性健康评估 (APACHE-II) 评分.
- 使用独立性估计方程的物流回归模型被用于分析艾滋病毒与死亡率的人口平均关联.
主要成果:
- 该研究包括177名艾滋病毒感染者和354名没有艾滋病毒的匹配人员.
- 艾滋病毒感染者在ICU (24.3%对15.3%) 和住院 (31.6%对20.1%) 的死亡率较高.
- 艾滋病毒与在ICU (1.69倍) 和在医院 (1.86倍) 死亡率的几率明显更高,调整为关键共变量. 没有发现与入院年份的显著相互作用.
结论:
- 尽管在护理方面取得了进展,但接受ICU治疗的艾滋病毒感染者与具有相似特征的HIV阴性对手相比,短期死亡率更高.
- 随着时间的推移,艾滋病毒感染者在重症监护室的结果有所改善,但死亡率的差异仍然存在.
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