急性脑膜炎患者的人口统计学特征和死亡风险因素:一项基于全国人口的观察研究。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2023-12-29 DOI:10.1002/ams2.920
Tetsuya Akaishi, Kunio Tarasawa, Kiyohide Fushimi, Nobuo Yaegashi, Masashi Aoki, Kenji Fujimori
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引用次数: 0

摘要

目的:急性脑膜炎包括细菌性、病毒性(无菌性)、真菌性、结核性和癌性脑膜炎。每种类型的死亡率和风险仍不确定。本研究旨在阐明每种脑膜炎的这些方面:本研究利用了日本全国行政诊断程序组合(DPC)数据库。结果:在47366222名急性脑膜炎患者中,有47366222人在DPC数据库中接受了治疗:在 47,366,222 名累计住院患者中,有 48,758 人(0.10%)因急性脑膜炎住院。脑膜炎的类型如下:细菌性脑膜炎 10,338 例,病毒/化脓性脑膜炎 29,486 例,真菌性脑膜炎 965 例,结核性脑膜炎 678 例,癌性脑膜炎 3790 例。细菌性和病毒性脑膜炎的发病年龄呈双峰分布,第一个高峰出现在 0-9 岁。只有病毒性脑膜炎的中位发病年龄低于 50 岁。癌性脑膜炎的死亡率最高(39%),其次是真菌性脑膜炎(21%),病毒性脑膜炎的死亡率最低(0.61%)。在所有脑膜炎类型中,死亡率随年龄增长而增加,但这一趋势在癌性脑膜炎中不太明显。与其他类型的脑膜炎相比,真菌性和结核性脑膜炎从入院到死亡的时间更长。细菌性脑膜炎中的金黄色葡萄球菌(调整后的几率比为1.71;P = 0.0016)和病毒性脑膜炎中的单纯疱疹病毒(调整后的几率比为1.53;P = 0.0467)显示出较高的死亡率:结论:不同类型的脑膜炎有不同的人口统计学特征和死亡率。结论:在不同类型的脑膜炎中观察到了不同的人口统计学特征和死亡率,不常见类型脑膜炎的高死亡率强调了进一步优化所需的诊断和治疗策略的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Demographic profiles and risk factors for mortality in acute meningitis: A nationwide population-based observational study

Aim

Acute meningitis encompasses bacterial, viral (aseptic), fungal, tuberculous, and carcinomatous meningitis. The rate and risks of mortality in each type remain uncertain. This study aimed to elucidate these aspects in each type of meningitis.

Methods

This study utilized Japan's nationwide administrative Diagnosis Procedure Combination (DPC) database. Patients with acute meningitis, treated at 1132 DPC-covered hospitals from 2016 to 2022, were enrolled.

Results

Among 47,366,222 cumulative hospitalized patients, 48,758 (0.10%) were hospitalized with acute meningitis. The types of meningitis were as follows: 10,338 with bacterial, 29,486 with viral/aseptic, 965 with fungal, 678 with tuberculous, and 3790 with carcinomatous meningitis. Bacterial and viral meningitis exhibited bimodal age distributions, with the first peak occurring at 0–9 years. The median onset age was below 50 years only in viral meningitis. The mortality rate was the highest in carcinomatous meningitis (39%), followed by fungal meningitis (21%), and the lowest in viral meningitis (0.61%). Mortality rates increased with age across all meningitis types, but this trend was less prominent in carcinomatous meningitis. The duration from admission to mortality was longer in fungal and tuberculous meningitis compared with other types. Staphylococcus aureus in bacterial meningitis (adjusted odds ratio 1.71; p = 0.0016) and herpes simplex virus in viral meningitis (adjusted odds ratio 1.53; p = 0.0467) exhibited elevated mortality rates.

Conclusion

Distinct demographic profiles and mortality rates were observed among different meningitis types. The high mortality rates in less common types of meningitis emphasize the necessity to further optimize the required diagnostic and treatment strategies.

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来源期刊
Acute Medicine & Surgery
Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-
自引率
12.50%
发文量
87
审稿时长
53 weeks
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