■本研究旨在确定在中国合并感染人类免疫缺陷病毒(HIV)和马尔尼菲Talaromyces(TM)的患者中与死亡率相关的危险因素,并建立风险预测模型。
■在2013年至2024年进行的这项回顾性队列分析中,使用逻辑回归模型分析了160例患者的综合临床数据,以识别死亡率预测因子并构建预测模型。另外36名患者组成了验证队列,这是专门为评估模型的预测价值而设计的。使用曲线下面积(AUC)评估模型性能。
■合并感染HIV/TM的住院患者的总死亡率为17.35%。中位年龄为35.0岁,男性占89.30%。此外,89.80%的患者报告发烧,87.76%的患者出现淋巴结肿大。与死亡率相关的关键独立危险因素包括年龄(比值比(OR):1.103,95%置信区间(CI)=1.033-1.178,P=0.003),降钙素原(PCT)水平(OR:1.270,95%CI=1.052-1.534,P=0.013),和尿素白蛋白比(UAR)(OR:1.491,95%CI=1.175-1.892,P<0.001)。高龄,PCT水平升高,和增加的UAR被确定为死亡的独立危险因素。此外,死亡率预测概率结合年龄,PCT,和UAR在HIV/TM共感染患者中表现出较高的预测价值。此外,AUC在验证组中显示出良好的辨别能力(AUC,0.898).
■高龄,PCT水平升高,UAR的增加显著决定了HIV/TM合并感染患者的死亡率。这些发现强调了使用实验室参数作为死亡率预测指标的潜力,促进临床实践中HIV/TM合并感染病例的早期识别。
UNASSIGNED: This study aimed to identify the risk factors associated with mortality among patients co-infected with human immunodeficiency virus (HIV) and Talaromyces marneffei (TM) in China, and develop a risk prediction model.
UNASSIGNED: In this retrospective cohort analysis conducted from 2013 to 2024, comprehensive clinical data from 160 patients were analyzed using a logistic regression model to identify mortality predictors and construct a predictive model. An additional 36 patients constituted the validation cohort, which was specifically designed to evaluate the predictive value of the model. Model performance was assessed using the area under the curve (AUC).
UNASSIGNED: The overall mortality rate for hospitalized patients with HIV/TM co-infection was 17.35 %. The median age was 35.0 years, and 89.30 % were male. Additionally, 89.80 % of the patients reported fever and 87.76 % presented with lymphadenopathy. Key independent risk factors associated with mortality included age (odds ratio (OR): 1.103, 95 % confidence interval (CI) = 1.033-1.178, P = 0.003), procalcitonin (PCT) levels (OR: 1.270, 95 % CI = 1.052-1.534, P = 0.013), and urea to albumin ratio (UAR) (OR: 1.491, 95 % CI = 1.175-1.892, P < 0.001). Advanced age, elevated PCT levels, and increased UAR were identified as independent risk factors of mortality. Furthermore, the mortality prediction probability combining age, PCT, and UAR exhibited a high predictive value in patients with HIV/TM co-infection. Additionally, the AUC showed a good discrimination ability in the validation group (AUC, 0.898).
UNASSIGNED: Advanced age, elevated PCT levels, and increased UAR significantly determine mortality in patients with HIV/TM co-infection. These findings underscore the potential of using laboratory parameters as predictive indicators of mortality, facilitating the early identification of HIV/TM co-infection cases in clinical practice.