背景:低收入和中等收入国家缺乏慢性低氧血症危险因素的数据。
目的:我们旨在量化肯尼亚住院成年人中潜在危险因素与慢性低氧血症之间的关联。
方法:在Eldoret的Moi教学和转诊医院进行了基于医院的病例对照研究,肯尼亚。成年住院患者在入院时进行筛查,并以1:2的病例与对照比例进行登记。病例为慢性低氧血症患者,定义为入院时静息氧饱和度(SpO2)<88%,出院后一个月SpO2<88%或,如果他们在随访前死亡,登记前6个月有记录的SpO2<88%。随机选择对照,按性别分层,在非低氧血症住院患者中。通过问卷调查和结构化图表审查收集数据。回归用于评估慢性低氧血症与年龄之间的关系,性别,吸烟状况,生物质燃料的使用,高程,以及自我报告的结核病和艾滋病毒诊断史。报告了赔率比(OR)和95%置信区间(CI)。
结果:该研究纳入了108例慢性低氧血症和240例非低氧血症对照。在多变量分析中,与对照组相比,慢性低氧血症病例年龄较大的几率显著增高(每5年增加OR1.2;95%CI:1.1-1.3),女性(OR3.6,95%CI:1.8-7.2),当前或以前的烟草使用(OR4.7,95%CI:2.3-9.6)和先前的结核病(OR11.8,95%CI:4.7-29.6),但没有增加艾滋病毒诊断和生物质燃料使用的几率。
结论:这些发现强调了肯尼亚既往结核病对慢性肺病的潜在影响,以及对结核病后肺病进一步研究的必要性。
Rationale: Data on risk factors for chronic hypoxemia in low- and middle-income countries are lacking. Objectives: We aimed to quantify the association between potential risk factors and chronic hypoxemia among adults hospitalized in Kenya. Methods: A hospital-based,
case-control study was conducted at Moi Teaching and Referral Hospital in Eldoret, Kenya. Adult inpatients were screened on admission and enrolled in a 1:2
case-to-control ratio. Cases were patients with chronic hypoxemia, defined as resting oxygen saturation as measured by pulse
oximetry (SpO2) ⩽ 88% on admission and either 1-month postdischarge SpO2 ⩽ 88% or, if they died before follow-up, documented SpO2 ⩽ 88% in the 6 months before enrollment. Control subjects were randomly selected, stratified by sex, among nonhypoxemic inpatients. Data were collected using questionnaires and structured chart review. Regression was used to assess the associations between chronic hypoxemia and age, sex, smoking status, biomass fuel use, elevation, and self-reported history of tuberculosis and human immunodeficiency virus diagnosis. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Results: We enrolled 108 chronically hypoxemic cases and 240 nonhypoxemic control subjects into our Chronic Hypoxemia among Kenyan Adults (CHAKA) cohort. In multivariable analysis, compared with control subjects, chronically hypoxemic cases had significantly higher odds of older age (OR, 1.2 per 5-year increase [95% CI, 1.1-1.3]), female sex (OR, 3.6 [95% CI, 1.8-7.2]), current or former tobacco use (OR, 4.7 [95% CI, 2.3-9.6]), and prior tuberculosis (OR, 11.8 [95% CI, 4.7-29.6]) but no increase in the odds of human immunodeficiency virus diagnosis and biomass fuel use. Conclusions: These findings highlight the potential impact of prior tuberculosis on chronic lung disease in Kenya and the need for further studies on posttuberculosis lung disease.