南非Chris Hani Baragwanath学术医院重症肺炎患儿的HIV暴露及其与儿科ICU结果的关系

K. Keeling, J. Price, K. Naidoo
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引用次数: 0

摘要

背景肺炎是南非5岁以下儿童死亡的主要原因之一,也是儿科重症监护室(PICU)入院的主要负担。然而,尽管这一弱势群体的规模越来越大,但人们对接触艾滋病毒的未感染(HIV-EU)肺炎儿童的PICU结果知之甚少。目标。确定未经感染的HIV暴露是否是PICU肺炎患儿死亡率和发病率的独立风险因素。方法。这项回顾性审查包括2013年1月1日至2014年12月31日期间入住Chris Hani Baragwanath学院医院PICU的所有肺炎患者。将患者分为未接触HIV(HIV-U)、HIV-EU和HIV感染者。对医疗记录进行审查,以确定PICU出院的存活率、PICU入院的持续时间和机械通气的持续时间。生存分析用于确定HIV感染/暴露与死亡率之间的关系,线性回归用于检查与住院时间和机械通气持续时间的关系。这项研究包括107名患者:54名为HIV-U;28例为HIV-EU;23例HIV阳性;2人的艾滋病毒状况不明。后果总体而言,84%(n=90)的患者在PICU出院后存活,根据HIV感染或暴露情况,存活率没有差异。与感染艾滋病毒的儿童相比,感染艾滋病毒的EU和感染艾滋病毒的U儿童的PICU入院时间和机械通气天数都显著缩短(分别为p=0.011和p=0.004)。结论在死亡率、PICU住院时间和机械通气时间方面,HIV-EU儿童的表现和HIV-U儿童相似。HIV感染与机械通气和ICU住院时间延长有关,但与病死率无关
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HIV exposure and its association with paediatric ICU outcomes in children admitted with severe pneumonia at Chris Hani Baragwanath Academic Hospital, South Africa
Background. Pneumonia is one of the leading causes of under-5 death in South Africa and accounts for a substantial burden of paediatric intensive care unit (PICU) admissions. However, little is known about PICU outcomes in HIV-exposed uninfected (HIV-EU) children with pneumonia, despite the growing size of this vulnerable population.Objectives. To determine whether HIV exposure without infection is an independent risk factor for mortality and morbidity in childrenadmitted to PICU with pneumonia.Methods. This retrospective review included all patients with pneumonia admitted to the PICU at Chris Hani Baragwanath AcademicHospital between 1 January 2013 and 31 December 2014. Patients were classified as HIV-unexposed (HIV-U), HIV-EU and HIV-infected.Medical records were reviewed to determine survival to PICU discharge, duration of PICU admission and duration of mechanicalventilation. Survival analysis was used to determine the association between HIV infection/exposure with mortality, and linear regression was used to examine the association with length of stay and duration of mechanical ventilation. This study included 107 patients: 54 were HIV-U; 28 were HIV-EU; 23 HIV-positive; and 2 had an unknown HIV status.Results. Overall, 84% (n=90) survived to PICU discharge, with no difference in survival based on HIV infection or exposure. Both HIV-EUand HIV-U children had significantly shorter PICU admissions and fewer days of mechanical ventilation compared with HIV-infectedchildren (p=0.011 and p=0.004, respectively).Conclusion. HIV-EU children behaved similarly to HIV-U children in terms of mortality, duration of PICU admission and length ofmechanical ventilation. HIV infection was associated with prolonged length of mechanical ventilation and ICU stay but not increasedmortality
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CiteScore
0.60
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0.00%
发文量
21
审稿时长
12 weeks
期刊最新文献
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