The Contribution of Ebola Viral Load at Admission and Other Patient Characteristics to Mortality in a Médecins Sans Frontières Ebola Case Management Centre, Kailahun, Sierra Leone, June-October 2014.
The Contribution of Ebola Viral Load at Admission and Other Patient Characteristics to Mortality in a Médecins Sans Frontières Ebola Case Management Centre, Kailahun, Sierra Leone, June-October 2014.
复制标题
DOI：
10.1093/infdis/jiv304
复制
发表时间：
2015-12-01
期刊：
影响因子：
--
通讯作者：
Van Herp M
中科院分区：
文献类型：
--
作者：
Fitzpatrick G;Vogt F;Moi Gbabai OB;Decroo T;Keane M;De Clerck H;Grolla A;Brechard R;Stinson K;Van Herp M
本文描述了无国界医生组织埃博拉病例管理中心（CMC）中与死亡率相关的患者特征，包括埃博拉病毒载量。
在2014年6月至10月期间收治的780名患者中，525人（67%）埃博拉检测呈阳性且结果已知。粗死亡率为51%（270/525）。76%（397/525）的患者有埃博拉病毒载量（全血样本）数据。单变量分析表明，入院时的病毒载量、年龄、入院前症状持续时间以及到CMC的距离与死亡率相关（P<0.05）。多变量模型预测，入院时病毒载量大于每毫升1000万拷贝（P<0.05，优势比>10）、年龄≥50岁（P = 0.08，优势比 = 2）以及入院前症状持续时间少于5天（P = 0.14）的患者死亡率较高。死亡的埃博拉患者中，意识模糊、腹泻和结膜炎的发生率显著更高（P<0.05）。
这些发现凸显了入院时病毒载量对死亡率结果的重要性，并且可用于将病毒载量大于1000万拷贝的病例分组安排到有更密集医疗支持的专门病房，以进一步降低死亡率。
This paper describes patient characteristics, including Ebola viral load, associated with mortality in a Médecins Sans Frontières Ebola case management centre (CMC). Out of 780 admissions between June and October 2014, 525 (67%) were positive for Ebola with a known outcome. The crude mortality rate was 51% (270/525). Ebola viral load (whole-blood sample) data were available on 76% (397/525) of patients. Univariate analysis indicated viral load at admission, age, symptom duration prior to admission, and distance traveled to the CMC were associated with mortality (P < .05). The multivariable model predicted mortality in those with a viral load at admission greater than 10 million copies per milliliter (P < .05, odds ratio >10), aged ≥50 years (P = .08, odds ratio = 2) and symptom duration prior to admission less than 5 days (P = .14). The presence of confusion, diarrhea, and conjunctivitis were significantly higher (P < .05) in Ebola patients who died. These findings highlight the importance viral load at admission has on mortality outcomes and could be used to cohort cases with viral loads greater than 10 million copies into dedicated wards with more intensive medical support to further reduce mortality.