Journal of epidemiology · 2017
Coexisting infectious diseases on admission as a risk factor for mechanical ventilation in patients with Guillain-Barré syndrome.
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Kobori Shinichiro, Kubo Tatsuhiko, Otani Makoto, Muramatsu Keiji, Fujino Yoshihisa, Adachi Hiroaki, Horiguchi Hiromasa, Fushimi Kiyohide, Matsuda Shinya
Аннотация
BACKGROUND: The aim of this study was to investigate patient characteristics on admission to hospital that increase the risk of subsequent mechanical ventilation (MV) use for patients with Guillain-Barré syndrome (GBS).
METHODS: We extracted data from the Japanese Diagnosis Procedure Combination (DPC) database for 4132 GBS patients admitted to hospital. Clinical characteristics of GBS patients with and without MV were compared. Multivariate logistic regression analyses were performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of requirement for MV with coexisting infectious diseases, after adjustment for potential confounding variables, age, sex, hospital type, and ambulance transportation.
RESULTS: In total, 281 patients required MV, and 493 patients had coexisting respiratory diseases on admission. After adjustment for covariates and stratification by coexisting respiratory diseases, multivariate logistic regression analysis revealed that coexisting cytomegaloviral (CMV) disease (OR 8.81; 95% CI, 2.34-33.1) and herpes simplex viral (HSV) infections (OR 4.83; 95% CI, 1.16-20.1) were significantly associated with the requirement for MV in the group without coexisting respiratory diseases.
CONCLUSION: Our findings suggest that coexisting CMV and HSV infections on admission might be significantly associated with increased risk of respiratory failure in GBS patients.
METHODS: We extracted data from the Japanese Diagnosis Procedure Combination (DPC) database for 4132 GBS patients admitted to hospital. Clinical characteristics of GBS patients with and without MV were compared. Multivariate logistic regression analyses were performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of requirement for MV with coexisting infectious diseases, after adjustment for potential confounding variables, age, sex, hospital type, and ambulance transportation.
RESULTS: In total, 281 patients required MV, and 493 patients had coexisting respiratory diseases on admission. After adjustment for covariates and stratification by coexisting respiratory diseases, multivariate logistic regression analysis revealed that coexisting cytomegaloviral (CMV) disease (OR 8.81; 95% CI, 2.34-33.1) and herpes simplex viral (HSV) infections (OR 4.83; 95% CI, 1.16-20.1) were significantly associated with the requirement for MV in the group without coexisting respiratory diseases.
CONCLUSION: Our findings suggest that coexisting CMV and HSV infections on admission might be significantly associated with increased risk of respiratory failure in GBS patients.