背景:目前对因急性病毒性呼吸道感染而住院的免疫功能低下患者的治疗指南有限。对急性病毒性呼吸道感染患者给予IVIG的临床和经济效益知之甚少。
目的:我们比较了接受IVIG和未接受IVIG的病毒性呼吸道感染免疫功能低下患者的临床和经济结果。
方法:我们对2011年至2016年在两个大型学术中心因呼吸道病毒感染住院的所有患者进行了回顾性队列研究,包括年龄数据,性别,病毒种类,免疫抑制型,和收到IVIG。结果包括死亡,医院再入院,住院时间(LOS),和重症监护病房(ICU)。
结果:共审查了270名患者的入院情况,35.6%收到IVIG。平均年龄40.6岁,50%为女性,74%为移植患者。最常见的病毒是鼻病毒(50.7%)。使用IVIG与较短的ICULOS显著相关(β=-0.534,P=0.012),住院LOS较长(β=0.887,P<0.01)。住院48小时内给予IVIG(n=229)与ICULOS较短(β=-2.08,P=0.001)和住院至少2天患者的住院LOS较短(β=-0.461,P=0.007)相关。再入院率或死亡没有显着差异。
结论:这种双中心,回顾性队列分析是首批评估IVIG对因呼吸道病毒感染住院的免疫功能低下患者的影响的研究之一.IVIG与较短的医院和ICULOS有关,尤其是在入院后48小时内给药。
BACKGROUND: Limited guidelines exist for treating immunocompromised patients
hospitalized for acute viral respiratory infection. Little is known about clinical and economic benefits of IVIG administration in patients with acute viral respiratory infections.
OBJECTIVE: We compared clinical and economic outcomes among immunocompromised patients
hospitalized with viral respiratory infections who received IVIG to those who did not.
METHODS: We performed a retrospective cohort study on all patients
hospitalized for a respiratory viral infection between 2011 and 2016 at two large academic centers including data on age, gender, virus species, immunosuppression type, and receipt of IVIG. Outcomes included death, hospital readmission, length of stay (LOS) in the hospital, and the intensive care unit (ICU).
RESULTS: A total of 270 patient admissions were reviewed, and 35.6% received IVIG. The average age was 40.6 years, 50% were female and 74% were transplant patients. The most common virus was rhinovirus (50.7%). Use of IVIG was significantly associated with a shorter ICU LOS (β=-0.534, P=0.012), and a longer hospital LOS (β=0.887, P<0.01). IVIG administered within 48 hours of hospitalization (n=229) was associated with a shorter ICU LOS (β=-2.08, P=0.001) and a shorter hospital LOS for patients
hospitalized at least 2 days (β=-0.461, P=0.007). There were no significant differences in readmission rates or death.
CONCLUSIONS: This double-center, retrospective cohort analysis is one of the first studies to evaluate the effect of IVIG on immunocompromised patients
hospitalized with respiratory viral infections. IVIG was associated with a shorter hospital and ICU LOS, especially when administered within 48 hours of admission.