血液恶性病和急性呼吸系统衰竭的住院患者的流行病学和结果
Anoosha Ponnapalli1, Aditya Sharma2, Mariam Fatima2
1Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
Hematology/oncology and stem cell therapy
|March 6, 2026
概括
急性呼吸衰竭 (ARF) 影响了超过12%的血液恶性瘤住院患者,显著增加死亡率和医疗保健成本. 侵入性机械通风 (IMV) 进一步增加了这些风险,强调了针对性干预的必要性.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 流行病学 流行病学
背景情况:
- 患有血液性恶性瘤的患者面临急性呼吸衰竭 (ARF) 的风险增加.
- 在这个患者群体中,ARF是重症监护室入院和死亡率的主要驱动因素.
- 了解ARF的影响对于改善血液恶性瘤患者的护理至关重要.
研究的目的:
- 在患有血液性恶性瘤的住院患者中描述ARF的流行病学.
- 分析与ARF相关的临床结果和医疗保健利用情况.
- 确定影响死亡率和资源使用的因素.
主要方法:
- 使用2016-2019年全国住院患者样本进行的回顾性队列研究.
- 使用ICD-10-CM代码识别患有血液性恶性瘤的成人住院病例.
- 基于ARF存在和侵入性机械通风 (IMV) 使用的分层.
主要成果:
- 在240万例血液性恶性瘤住院患者中,ARF发生在12.5%的患者中.
- 接受ARF治疗的患者年龄较大,并发病率较高,败血症和急性损伤 (AKI) 的发生率较高.
- 住院死亡率为ARF的22.7%,而没有ARF的2.2%;IMV使用 (27.7%的ARF病例) 的死亡率为49.7%,住院时间更长,成本更高.
- 在IMV患者中死亡的独立预测因素包括老年,AKI和中性质减退.
结论:
- ARF影响超过10%的住院血液恶性瘤患者,与增加的死亡率和医疗保健利用率有关.
- 虽然结果有所改善,但ARF,特别是IMV,仍然是一个重大挑战.
- 早期风险分层和有针对性的干预措施对于这种高风险人群至关重要.
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