在老年患者中死亡率的预后模型,这些老年患者患有斯坦诺托福蒙纳斯马尔托菲利亚细菌病
Hoang-Van Quang1,2, Le-Thi Kim Nhung1, Pham-Thi Thanh Thuy2
1Department of Internal Medicine, Faculty of Medicine, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh Street, Ward 13, District 4, Ho Chi Minh City.Vietnam.
概括
患有斯坦诺托福蒙纳斯 (Stenotrophomonas maltophilia bacteremia) 的老年患者面临高死亡率. 年龄,SOFA分数和APACHE II分数是关键的危险因素. 结合这些因素的模型提供了最好的预测.
科学领域:
- 传染性疾病 传染性疾病
- 老年医学 老年医学
- 临界护理医学 临界护理医学
背景情况:
- 菌群Stenotrophomonas maltophilia bacteremia对老年人构成了重大威胁.
- 高死亡率强调了需要更好的风险分层和预后工具在这个人口群体.
- 关于患有S. maltophilia bacteremia的老年患者死亡率的特定风险因素和预测模型的研究有限.
研究的目的:
- 确定诊断为Stenotrophomonas maltophilia bacteremia的老年患者死亡的独立风险因素.
- 开发和评估预后模型,以预测这种脆弱患者群体的死亡率.
- 为临床医生提供改善患者管理和临床决策的工具.
主要方法:
- 进行了一项回顾性研究,涉及195名患有S. maltophilia bacteremia的老年患者 (≥60岁).
- 收集的数据包括人口和临床特征,以及SOFA和APACHE II分数.
- 多变量分析和贝叶斯模型平均值被用来识别风险因素和开发预测模型.
主要成果:
- 研究队列的整体死亡率为37.4%.
- 死亡的重要独立风险因素包括晚年 (aOR 1.08),较高的SOFA得分 (aOR 1.38) 和升高的APACHE II得分 (aOR 1.10).
- 最准确的预后模型结合了年龄,SOFA和APACHE II分数 (AUC 0.884),而使用年龄和SOFA分数的更简单模型也证明了临床实用性 (AUC 0.874).
结论:
- 在老年人中,Stenotrophomonas maltophilia bacteremia与严重的结果和高死亡率有关.
- 年龄,SOFA分数和APACHE II分数是死亡率的关键预测指标.
- 结合这些因素的预测模型,特别是年龄和SOFA分数的组合,可以帮助临床实践.
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