A multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus.
A multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus.
复制标题
人类偏肺病毒引起的严重病毒性呼吸道感染儿童的多中心结果分析。
DOI：
10.1097/pcc.0b013e3182720fc7
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Scafidi,Susanna
中科院分区：
文献类型：
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作者：
Spaeder,MichaelC;Custer,JasonW;Bembea,MelaniaM;Aganga,DevonO;Song,Xiaoyan;Scafidi,Susanna
目的：研究人偏肺病毒对严重病毒性呼吸道感染儿童发病率和死亡率结局的影响。设计：回顾性队列研究。设置：ICU，PICU或心脏ICU，在三个城市学术三级保健儿童医院。患者：2010年1月至2011年6月期间因实验室确认的人偏肺病毒感染而入住ICU的所有患者。干预措施：我们收集人口统计学和临床数据，并分析相关的发病率和死亡率结局。测量和主要结果：在研究期间，有111例实验室确认的人偏肺病毒患者在三个参与机构之一入住ICU。中位住院时间为7天（四分位距4-18天），中位ICU住院时间为4天（四分位距1-10天）。10例患者（9%）未能存活出院。与死亡率增加相关的易感因素包括女性（p= 0.002）、慢性疾病（p= 0.04）和医院获得的人偏肺病毒感染（p= 0.006）。调整女性性别、慢性疾病、医院感染和疾病严重程度评分后，logistic回归分析表明，女性性别、医院感染和慢性疾病各自独立增加死亡率（优势比分别为14.8、10.7和12.7）。我们的结果分析表明，有大量的发病率和死亡率与严重的病毒性呼吸道感染，由于人类偏肺病毒在儿童。女性、医院获得的人偏肺病毒感染和慢性疾病的存在各自独立地增加死亡率。从资源利用的角度来看，人偏肺病毒对ICU的疾病负担可能相当大。
Objective:To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection.Design:Retrospective cohort study.Setting:ICU, either PICU or cardiac ICU, at three urban academic tertiary care children’s hospitals.Patients:All patients admitted to an ICU with laboratory-confirmed human metapneumovirus infection between January 2010 and June 2011.Interventions:We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes.Measurements and Main Results:There were 111 patients with laboratory-confirmed human metapneumovirus admitted to an ICU at one of the three participating institutions during the period of study. The median hospital length of stay was 7 days (interquartile range 4–18 days) and median ICU length of stay was 4 days (interquartile range 1–10 days). Ten patients (9%) did not survive to discharge. Predisposing factors associated with increased mortality included female gender (p= 0.002), presence of a chronic medical condition (p= 0.04), and hospital acquisition of human metapneumovirus infection (p= 0.006). Adjusting for female gender, chronic medical conditions, hospital acquisition of infection and severity of illness score, logistic regression analysis demonstrated that female gender, hospital acquisition of infection, and chronic medical conditions each independently increased the odds of mortality (odds ratios 14.8, 10.7, and 12.7, respectively).Conclusions:Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.