摘要
目的探讨严重急性呼吸综合征(SARS)患者流行病学诊断依据与病死率的关系。方法回顾性分析临床诊断的304例SARS患者的流行病学证据(包括传播他人病例、群发病例和散发病例),对其与预后的关系进行统计分析。结果SARS患者病死率为8.2%,不同流行病学诊断依据与病死率的关系显示,散发、群发和传播他人的患者有病死率增加的趋势穴病死率分别为3.9%、11.4%和17.2%熏χ2trend=7.561熏P<0.01雪;经趋势卡方检验,SARS的病死率随年龄的增大而显著升高(χ2trend=27.024熏P<0.01);男性大于女性(12.2%vs5.5%)。多元Logistic回归模型显示,流行病学暴露水平、年龄和性别是影响预后的因素。前进法观察流行病学暴露水平、年龄、性别OR值的动态变化,发现流行病学暴露水平是独立的与SARS患者死亡相关的预后因素。结论流行病学诊断依据是与SARS患者病死率有关的独立预后因素,具有传播他人史的SARS患者较散发和群发病例预后差,病死率高。
Objective To investgate the relationship between epidemiological diagnosis and fatality rate in patients with severe acute respiratory syndrome(SARS). Methods Epidemiological evidences and the outcomes of 304 patients with confirmed SARS were retrospectively analyzed. Patients included highly contagious cases, cluster cases, and sporadic cases. Results The case fatality rate was 8.2%. The fatality rate had a tendency of increase in an order of sporadic cases, cluster cases, and highly contagious cases(3.9%, 11.4%, and 17.2%, respectively,χ2trend=7.561, P < 0.01). Chi square-test also proved that the fatality rate was higher in older people(χ2trend=27.024, P < 0.01) and in male(male vs female: 12.2% vs 5.5%). A logistic regression model showed that the epidemiological evidence, age, and gender were correlated to fatality rate. By observing changes of the odds ratio for epidemic evidence, age, and gender using forward method, we found epidemic evidence was an independent risk factor related to fatality rate in SARS patients. Conclusion The epidemiological evidence is an independent factor related to fatality rate in SARS patients. Highly contagious case has a worse prognosis and higher fatality rate than sporadic cases and cluster cases.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2004年第3期247-250,共4页
Acta Academiae Medicinae Sinicae
基金
国家SARS防治紧急科技行动基金(2003AA208102)
北京市自然科学基金(7034052)~~
关键词
严重急性呼吸综合征
病死率
流行病学
severe acute respiratory syndrome
fatality rate
epidemiology
