主页 > 医学前沿 >
【medical-news】社区获得性肺炎患者早期死亡的原
The first 48 hours of evolution of patients with community-acquired pneumonia (CAP) are critical. The aim of this study was to determine the frequency, causes, and factors associated with early mortality in CAP.
Prospective observational study of non-immunocompromised adults hospitalized with CAP (1995–2005). Early deaths, defined as death due to any cause 48 hours after admission, were compared with all patients who survived >48 hours. Furthermore, early deaths were compared with late deaths (patients who died >48 hours) and with survivors.
Of 2, 457 patients, 57 died 48 hours (2.3%). Overall mortality was 7.7%. The main causes of early mortality were respiratory failure and septic shock/multiorgan failure. Independent factors associated with early deaths were increased age, altered mental status at presentation, multilobar pneumonia, shock at admission, pneumococcal bacteremia, and discordant empiric antibiotic therapy.
Current early mortality is relatively low and caused by pneumonia-related factors. It occurs mainly among the elderly and patients presenting with altered mental status, multilobar pneumonia, and septic shock. Pneumococcal bacteremia and discordant antibiotic therapy mainly due to lack of coverage against P. aeruginosa are also significant risk factors.
Eur Respir J 2008, doi:10.1183/09031936.00128107
社区获得性肺炎患者早期死亡的原因及其危险因素
社区获得性肺炎最初48h的病情演变对预后非常关键，本研究旨在确定CAP早期死亡发生的频率、病因及相关因素。
前瞩性观察研究1995–2005年间无免疫抑制的成年住院CAP患者，无论任何原因凡入院后 48h死亡的规定为早期死亡并与生存>48 h的患者比较，此外，将早期死亡与迟发死亡(>48h死亡)及存活者（资料）比较。
2457例患者，57例 48h死亡(2.3%)，总死亡率为7.7%；早期死亡主要原因为呼吸衰竭、感染性休克/多脏器衰竭。与早期死亡有关的独立因子为年龄增加、精神状态改变、多叶肺炎、入院时休克、肺炎球菌菌血症及不适当的经验性抗菌素治疗。
目前CAP早期死亡率相对较低，通常为肺炎相关的因素所致，早期死亡主要发生于老年病人、精神状态改变、多叶肺炎、感染性休克、肺炎球菌菌血症及未覆盖铜绿假单胞菌的不适当经验性抗菌素治疗。 [标签:content1][标签:content2]
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-09-17 06:36
医学,生命科学网