High mortality from viral pneumonia in patients with cancer
High mortality from viral pneumonia in patients with cancer
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DOI：
10.1080/23744235.2019.1592217
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发表时间：
2019-05-10
影响因子：
5.8
通讯作者：
Lee, Yoon-Seon
中科院分区：
文献类型：
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作者：
Kim, Youn-Jung;Lee, Eu Sun;Lee, Yoon-Seon
背景：随着诊断方法的进步，病毒感染在成年肺炎患者中越来越被认识到，其结果可能是致命的，尤其是高危患者。我们的目的是检查成人病毒性肺炎的临床特征，并确定与这些患者短期死亡率的相关因素。方法：连续纳入2010年1月至2015年12月诊断为病毒性肺炎的成年患者。通过审查电子病历收集数据。主要结局是 30 天死亡率。结果：共纳入病毒性肺炎患者1503例，平均年龄66.0岁，男性占60%。最常见的病毒病原体是鼻病毒，其次是流感病毒和副流感病毒（PIV）。病毒-细菌混合感染和多种病毒感染分别占24.5%和5.2%。总患者的 30 天死亡率为 7.1%，并且根据病毒病原体没有差异。然而，癌症患者因 PIV（12.3% vs. 3.8%，p < .05）和冠状病毒（24.4% vs. 3.0%，p < .01）感染的死亡率高于非癌症患者。在多变量分析中，年龄（≥ 65）（OR 1.66，95% CI：1.06-2.60）、病毒-细菌混合感染（OR 1.61，95% CI：1.05-2.48）、恶性肿瘤（OR 2.26，95% CI：1.50-3.40）和初次就诊时休克（OR 2.12，95% CI：1.03-4.37）与死亡率显着相关。结论：成人患者病毒性肺炎的死亡率较高。年老、病毒细菌合并感染、潜在恶性肿瘤和初始休克是死亡率的独立预测因素。
Background: With the advancement of diagnostic methods, a viral infection is increasingly recognized in adult patients with pneumonia and the outcomes can be fatal especially in high-risk patients. We aimed to examine the clinical characteristics of adults with viral pneumonia and also to determine the associated factors with short-term mortality in those patients. Methods: Adult patients who were diagnosed as viral pneumonia between January 2010 and December 2015 were consecutively included. Data were collected through reviews of electronic medical records. The primary outcome was 30-day mortality. Results: A total of 1503 patients with viral pneumonia were included with a mean age of 66.0 years and male predominance in 60%. The most common viral pathogen was rhinovirus, followed by influenza virus and parainfluenza virus (PIV). Viral-bacterial co-infection and multiple viral infections were found in 24.5% and 5.2%, respectively. The 30-day mortality was 7.1% in total patients and it was not different according to viral pathogens. However, cancer patients had higher mortality than non-cancer patients for the PIV (12.3% vs. 3.8%, p < .05) and coronavirus (24.4% vs. 3.0%, p < .01) infections. On the multivariate analysis, old age (>= 65) (OR 1.66, 95% CI: 1.06-2.60), viral-bacterial co-infection (OR 1.61, 95% CI: 1.05-2.48), malignancy (OR 2.26, 95% CI: 1.50-3.40), and shock at the initial presentation (OR 2.12, 95% CI: 1.03-4.37) were significantly associated with mortality. Conclusions: The mortality from viral pneumonia was high in adult patients. Old age, viral-bacterial co-infection, underlying malignancy, and initial shock were independent predictors of mortality.