高血压与流感住院患者治疗结局的关联性研究

Association between hypertension and outcome of hospitalized influenza patients

目的高血压是流感住院患者最常见的基础病,本研究旨在探索高血压与流感患者住院结局的关联性。方法选取2016年10月1日至2019年4月30日确诊流感的严重急性呼吸道感染(Severe acute respiratory infection,SARI)住院患者为研究对象,以单纯患有高血压者作为高血压组,无任何基础病者作为对照组,随访两组的治疗过程,比较治疗结局,并采用多因素COX比例风险模型探索高血压对流感病例住院天数的影响。结果共纳入流感住院病例120例,其中高血压组53例,对照组67例。高血压组与对照组的年龄中位数分别为72岁(IQR:66-79)和63岁(IQR:58-78),差异有统计学意义(P=0.008)。高血压组与对照组患者的治愈出院率分别为98.11%和100%,差异无统计学意义(P=0.442);两组患者的住院天数分别为9天(IQR:8-14)和10天(IQR:7-12天),差异无统计学(P=0.269)。多因素回归分析显示,高血压组相对于对照组流感病例住院时间的差异无统计学意义(HR=0.82,95%CI:0.56-1.19);随着年龄增大出院的风险比下降(HR=0.98,95%CI:0.97-1.00),即年龄大者住院时间长。结论高血压不是导致流感患者住院时间延长或出现死亡结局的独立危险因素,年龄增长是导致住院时间延长的风险因素。

Objective Hypertension is the most common underlying disease among hospitalized influenza patients.The study aimed to explore the association between hypertension and the outcome of hospitalized influenza patients.Methods Hospitalized patients with severe acute respiratory infection(SARI)and laboratory-confirmed influenza from October 1,2016 to April 30,2019 were recruited as study subjects.Patients with hypertension as unique underlying diseases were selected as the exposure group and the patients without any underlying diseases were selected as the control group.Treatment procedures of patients in both groups were followed to compared the outcomes.Cox proportional hazards model was used to investigate the impact of hypertension on the length of hospitalization.Results A total of 120 hospitalized influenza patients were enrolled,including 53 patients in hypertension group and 67 in the control group.The median ages of both groups were 72 years old(IQR:66-79)and 63 years years(IQR:58-78),respectively.The difference was statistically significant(P=0.008).The discharged rates with full recovery in hypertension and control groups were 98.11%and 100%,respectively and the difference was not statistically significant(P=0.442).The length of hospitalization were 9 days(IQR:8-14)and 10 days(IQR:7-12),respectively and the difference was not statistically significant(P=0.269).Multivariable regression tests indicated that the difference in days of hospitalization between hypertension and control groups was not statistically significant(HR=0.82,95%CI:0.56-1.19).The risk of discharging decreased with increasing age,or elder patients tended to have delayed discharge(HR=0.98,95%CI:0.97-1.00).Conclusions Hypertension is not the independent risk factor of death and delayed discharge among hospitalized influenza patients.Increased age is a risk factor of delayed discharge.