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Κλινικοί και εργαστηριακοί παράγοντες σε ασθενείς με λοιμώξεις του κατώτερου αναπνευστικού συστήματος

Σκοπός της παρούσας μελέτης ήταν να αξιολογηθεί το αγγειομετατρεπτικό ένζυμο στον ορό των ασθενών με πνευμονία, ως διαγνωστικός ή/και προγνωστικός δείκτης της νόσου και γενικά να μελετηθούν οι διάφοροι προγνωστικοί παράγοντες στις λοιμώξεις του κατώτερου αναπνευστικού συστήματος. / Objective: The aim of this study was to determine prognostic factors of outcome in patients with lower respiratory tract infections (LRTIs). LRTIs are an heterogeneous group of disorders, including acute bronchitis, pneumonia, superinfection of chronic bronchitis and flu. The recent publications of several prognostic factors of outcome address specific conditions such as pneumonia or bronchitis, while general practitioners cannot usually differentiate between these conditions in current practice. Methodology: A total of 616 patients with LRTIs were retrospectively reviewed with regard to epidemiological, clinical, laboratory and radiographic data. The prognostic analysis included an univariate as well as a multivariate approach, in order to identify parameters associated with death. Results: The parameters found to be significantly different between survivors and non survivors in the univariate analysis, were respiratory rate (p<0,01), oxygen partial pressure (PaO2) (p<0,001), heart rate (p<0,0003), systolic and diastolic blood pressure (p<0,047 and (p<0,022, respectively), platelet count (p<0,045), urea (p<0,002), creatinine Objective: The aim of this study was to determine prognostic factors of outcome in patients with lower respiratory tract infections (LRTIs). LRTIs are an heterogeneous group of disorders, including acute bronchitis, pneumonia, superinfection of chronic bronchitis and flu. The recent publications of several prognostic factors of outcome address specific conditions such as pneumonia or bronchitis, while general practitioners cannot usually differentiate between these conditions in current practice. Methodology: A total of 616 patients with LRTIs were retrospectively reviewed with regard to epidemiological, clinical, laboratory and radiographic data. The prognostic analysis included an univariate as well as a multivariate approach, in order to identify parameters associated with death. Results: The parameters found to be significantly different between survivors and non survivors in the univariate analysis, were respiratory rate (p<0,01), oxygen partial pressure (PaO2) (p<0,001), heart rate (p<0,0003), systolic and diastolic blood pressure (p<0,047 and (p<0,022, respectively), platelet count (p<0,045), urea (p<0,002), creatinine (p<0,002), previous admission in the hospital the last year (p<0,033), and cavitations in chest radiograph (p<0,047). In multivariate analysis, the only statistically significant risk factors were PaO2 (odds ratio (OR) =0,8574; 95% confidence interval (CI) 0,7499-0,9802 in non survivors compared to survivors) and heart rate (OR=1,063; 95% CI 1,0052-1,1241 in non survivors compared to survivors). Conclusions: LRTIs remain a widespread problem and have a significant impact on primary healthcare resources. The great variability seen in rates of hospital admission and lengths of stay in part reflects uncertainty among physicians in assessing the severity of the illness. According to our data, PaO2 and heart rate, were most closely associated with death in patients with LRTIs. These predictor variables are all explicitly defined and can be readily assessed at the time of patient presentation.

Identiferoai:union.ndltd.org:upatras.gr/oai:nemertes:10889/350
Date26 June 2007
CreatorsΤρακαδά, Γεωργία Π.
ContributorsΣπυρόπουλος, Κωνσταντίνος, Trakada, Georgia P., Γώγος, Χαράλαμπος, Μπασιάρης, Χαράλαμπος, Σπυρόπουλος, Κωνσταντίνος
Source SetsUniversity of Patras
Languagegr
Detected LanguageEnglish
TypeThesis
RelationΗ ΒΥΠ διαθέτει αντίτυπο της διατριβής σε έντυπη μορφή στο βιβλιοστάσιο διδακτορικών διατριβών που βρίσκεται στο ισόγειο του κτιρίου της.

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