Association Between Cytomegalovirus Reactivation and Clinical Outcomes in Immunocompetent Critically Ill Patients: A Systematic Review and Meta-Analysis.
Association Between Cytomegalovirus Reactivation and Clinical Outcomes in Immunocompetent Critically Ill Patients: A Systematic Review and Meta-Analysis.
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免疫能力患者的巨细胞病毒重新激活与临床结局之间的关联：系统评价和荟萃分析。
DOI：
10.1093/ofid/ofx029
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发表时间：
2017
影响因子：
4.2
通讯作者：
Sligl WI
中科院分区：
文献类型：
--
作者：
Lachance P;Chen J;Featherstone R;Sligl WI
我们系统综述的目的是调查巨细胞病毒(CMV)重新激活与免疫功能正常的危重患者预后之间的关系。我们在电子数据库和灰色文献中搜索1990年至2016年10月发表的原始研究和摘要。这项综述仅限于包括严重免疫能力低下患者在内的研究。巨细胞病毒再激活定义为聚合酶链式反应阳性、pp65抗原血症或血液或支气管肺泡灌洗液中的病毒培养。选定的以患者为中心的结果包括死亡率、机械通气持续时间、是否需要肾脏替代治疗(RRT)和医院感染。卫生资源利用结果包括重症监护病房和住院时间。共纳入22项研究。在我们的初步分析中，CMV重新激活与ICU死亡率(优势比[OR]，2.55；95%可信区间[CI]，1.87-3.47)、总死亡率(OR，2.02；95%CI，1.60-2.56)、机械通气时间(平均差异6.60天；95%CI，3.09-10.12)、医院感染(OR，3.20；95%CI，2.05-4.98)、需要RRT(OR，2.37；95%可信区间1.31~4.31)和ICU住院天数(平均相差8.18天；95%可信区间6.14~10.22)。此外，还进行了大量的敏感性分析。在这项荟萃分析中，在危重病人中，巨细胞病毒的重新激活与较差的临床结果和较高的卫生资源利用率有关。然而，目前尚不清楚CMV重新激活是否起到了因果作用，或者它是否是更严重疾病的替代品。
The aim of our systematic review was to investigate the association between cytomegalovirus (CMV) reactivation and outcomes in immunocompetent critically ill patients. We searched electronic databases and gray literature for original studies and abstracts published between 1990 and October 2016. The review was limited to studies including critically ill immunocompetent patients. Cytomegalovirus reactivation was defined as positive polymerase chain reaction, pp65 antigenemia, or viral culture from blood or bronchoalveolar lavage. Selected patient-centered outcomes included mortality, duration of mechanical ventilation, need for renal replacement therapy (RRT), and nosocomial infections. Health resource utilization outcomes included intensive care unit and hospital lengths of stay. Twenty-two studies were included. In our primary analysis, CMV reactivation was associated with increased ICU mortality (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.87–3.47), overall mortality (OR, 2.02; 95% CI, 1.60–2.56), duration of mechanical ventilation (mean difference 6.60 days; 95% CI, 3.09–10.12), nosocomial infections (OR, 3.20; 95% CI, 2.05–4.98), need for RRT (OR, 2.37; 95% CI, 1.31–4.31), and ICU length of stay (mean difference 8.18 days; 95% CI, 6.14–10.22). In addition, numerous sensitivity analyses were performed. In this meta-analysis, CMV reactivation was associated with worse clinical outcomes and greater health resource utilization in critically ill patients. However, it remains unclear whether CMV reactivation plays a causal role or if it is a surrogate for more severe illness.
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影响因子：
3.7
作者：
Lachance P;Chen J;Featherstone R;Sligl W
通讯作者：
Sligl W
影响因子：
7.3
作者：
Filteau S;Rowland-Jones S
通讯作者：
Rowland-Jones S
影响因子：
3.7
作者：
Frantzeskaki, Frantzeska G.;Karampi, Eirini-Sofia;Dimopoulou, Ioanna
通讯作者：
Dimopoulou, Ioanna
影响因子：
8.8
作者：
Heininger, A;Jahn, G;Hamprecht, K
通讯作者：
Hamprecht, K
DOI：
10.1186/cc10069
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Heininger A;Haeberle H;Fischer I;Beck R;Riessen R;Rohde F;Meisner C;Jahn G;Koenigsrainer A;Unertl K;Hamprecht K
通讯作者：
Hamprecht K