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首页> 外文期刊>American Journal of Blood Research >Clinical factors predictive of mortality in acute leukemia patients with febrile neutropenia
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Clinical factors predictive of mortality in acute leukemia patients with febrile neutropenia

机译：急性白血病急性白血病患者死亡率的临床因素

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Background: Acute leukemia is mainly treated with chemotherapy leading to febrile neutropenia (FN). There is limited data on clinical factors predictive of mortality in adults with acute leukemia and FN. Methods: This was a retrospective cohort study and enrolled adult patients, diagnosed as acute leukemia, and developed FN. The eligible patients were admitted and followed up with mortality as the primary outcome. A stepwise, multivariate logistic regression analysis was used to find predictors for mortality. Results: There were 203 patients met the study criteria. Of those, 14 patients died (6.89%). AML was the most common type of acute leukemia with FN (64.04%). There were five remaining factors in the final model: AML, FN at admission, prolong broad spectrum antibiotics, lower respiratory tract infection, and Aspergillosis. Only lower respiratory tract infection was significant with adjusted odds ratio of 7.794 (95% CI of 1.549, 39.212). The Hosmer-Lemeshow Chi square was 2.74 ( p value 0.907). The lower respiratory tract infection group had higher proportions of Gram negative and fungus than the non-lower respiratory tract infection group; specifically E. coli (p 0.003), and Aspergillus (P 0.001). Conclusions: There were two independent predictors of mortality in acute leukemia patients with FN: septic shock and lower respiratory tract infection regardless of leukemia type or pathogen. E. coli and Aspergillus were more common in those with lower respiratory tract infection than those without. No specific pathogens were found in cases of septic shock.
机译：背景：急性白血病主要用化疗治疗，导致发热中性粒细胞率（FN）。有关临床因素的数据有限的数据，预测急性白血病和FN的成人死亡率。方法：这是一项回顾性队列研究和注册成年患者，被诊断为急性白血病，并开发FN。符合条件的患者被录取并随访，以死亡率为主要结果。逐步地，多变量逻辑回归分析用于寻找死亡率的预测因子。结果：有203名患者达到了研究标准。其中14名患者死亡（6.89％）。 AML是最常见的急性白血病类型（64.04％）。最终模型中有五个剩余因素：AML，FN入院，延长广谱抗生素，低呼吸道感染和曲霉病。只有下呼吸道感染才具有7.794（95％CI为1.549,39.212）的较低呼吸道感染。 Hosmer-Lemeshow Chi广场为2.74（P值0.907）。低呼吸道感染组比非低级呼吸道感染组具有更高的革兰氏阴性和真菌的比例;特别是大肠杆菌（P <0.003）和曲霉菌（P <0.001）。结论：急性白血病FN患者中有两种独立预测因素：无论白血病类型还是病原体，脓肠梗阻和降低呼吸道感染。大肠杆菌和曲霉在呼吸道感染较低的人中更常见。在脓毒症休克的情况下没有发现任何特定病原体。

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