PEDIATRIC INVESTIGATORS COLLABORATIVE NETWORK ON INFECTIONS IN CANADA (PICNIC) PROSPECTIVE-STUDY OF RISK-FACTORS AND OUTCOMES IN PATIENTS HOSPITALIZED WITH RESPIRATORY SYNCYTIAL VIRAL LOWER RESPIRATORY-TRACT INFECTION
PEDIATRIC INVESTIGATORS COLLABORATIVE NETWORK ON INFECTIONS IN CANADA (PICNIC) PROSPECTIVE-STUDY OF RISK-FACTORS AND OUTCOMES IN PATIENTS HOSPITALIZED WITH RESPIRATORY SYNCYTIAL VIRAL LOWER RESPIRATORY-TRACT INFECTION
复制标题
DOI：
10.1016/s0022-3476(95)70547-3
复制
发表时间：
1995-02-01
影响因子：
5.1
通讯作者：
HAMMOND, G
中科院分区：
文献类型：
--
作者：
WANG, EEL;LAW, BJ;HAMMOND, G
目的：了解呼吸道合胞病毒下呼吸道感染（RSV LRI）的发病情况，并量化各种危险因素的相关发病率。设计：前瞻性队列研究。受试者：在7个中心住院的RSV LRIs患者如果年龄小于2岁，或任何年龄的住院患者如果有潜在的心脏或肺部疾病或免疫抑制，均有资格参加研究。测量和结果：入组患者（n = 689）和符合条件但未入组患者（n = 191）在年龄、病程、基础疾病比例、重症监护使用和通气方面相似。在登记的患者中，156人有潜在疾病。353例患者的分离株可分型：A亚组102株，B亚组250株，两种抗血清均可分型1株。呼吸道合胞病毒（RSV）的平均住院时间为7天；重症监护110例，机械通气63例，死亡6例。回归模型用于预测三个结果：rsv相关的住院时间、重症监护病房住院和通气治疗。除了先前描述的增加发病率的危险因素，如基础疾病、缺氧、早产和年幼，其他三个因素被发现与复杂的住院治疗显著相关：土著种族（由母亲种族定义）、住院前急性疾病期间的呼吸暂停或呼吸停止史，以及入院时胸片显示的肺实变。RSV亚组、家庭收入和日托出勤与这些结果无显著相关。
Objective: To provide information on disease attributable to respiratory syncytial viral lower respiratory tract infection (RSV LRI) and to quantify the morbidity associated with various risk factors.Design: Prospective cohort study.Subjects: Patients hospitalized with RSV LRIs at seven centers were eligible for study if they were younger than 2 years of age, or hospitalized patients of any age if they had underlying cardiac or pulmonary disease or immunosuppression.Measurements and results: Enrolled (n = 689) and eligible but not enrolled (n = 191) patients were similar in age, duration of illness and proportion with underlying illness, use of intensive care, and ventilation. Of the enrolled patients, 156 had underlying illness. The isolates from 353 patients were typeable: 102 isolates were subgroup A, 250 were subgroup B, and one isolated grouped with both antisera. The mean hospital stay attributable to respiratory syncytial virus (RSV) was 7 days; 110 patients were admitted to intensive care units, 63 were supported by mechanical ventilation, and 6 patients died. Regression models were developed for the prediction of three outcomes: RSV-associated hospital duration,intensive care unit admission, and ventilation treatment. In addition to previously described risk factors for an increased morbidity, such as underlying illness, hypoxia, prematurity and young age, three other factors were found to be significantly associated with complicated hospitalization: aboriginal race (defined by maternal race), a history of apnea or respiratory arrest during the acute illness before hospitalization, and pulmonary consolidation as shown on the chest radiograph obtained at admission. The RSV subgroup, family income, and day care attendance were not significantly associated with these outcomes.