{"id":25670,"date":"2024-05-05T04:56:00","date_gmt":"2024-05-04T20:56:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25670"},"modified":"2024-05-05T06:43:00","modified_gmt":"2024-05-04T22:43:00","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%87%8d%e7%97%87%e6%82%a3%e8%80%85%e6%b5%81%e6%84%9f%e7%9b%b8%e5%85%b3%e8%82%ba%e6%9b%b2%e9%9c%89%e8%8f%8c%e7%97%85%e7%9a%84%e5%8f%91%e7%97%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25670","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u91cd\u75c7\u60a3\u8005\u6d41\u611f\u76f8\u5173\u80ba\u66f2\u9709\u83cc\u75c5\u7684\u53d1\u75c5\u7387\uff0c\u5371\u9669\u56e0\u7d20\uff0c\u4e34\u5e8a\u7279\u5f81\u548c\u9884\u540e"},"content":{"rendered":"\n<p>Chest Infections: Original Research<\/p>\n\n\n\n<h1 class=\"wp-block-heading\" id=\"screen-reader-main-title\">Prevalence, Risk Factors, Clinical Features, and Outcome of Influenza-Associated Pulmonary Aspergillosis in Critically Ill Patients: A Systematic Review and Meta-Analysis<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Lawrence Y.\u00a0Lu,\u00a0Hui Min\u00a0Lee,\u00a0Andrew\u00a0Burke, et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Chest 2024; 165: 540-558<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\"><a rel=\"noreferrer noopener\" href=\"https:\/\/doi.org\/10.1016\/j.chest.2023.09.019\" target=\"_blank\">https:\/\/doi.org\/10.1016\/j.chest.2023.09.019<\/a><\/h3>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0010\">Background<\/h3>\n\n\n\n<p id=\"abspara0010\">Influenza-associated pulmonary aspergillosis (IAPA) increasingly is being reported in critically ill patients. We conducted this systematic review and meta-analysis to examine the prevalence, risk factors, clinical features, and outcomes of IAPA.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0015\">Study Question<\/h3>\n\n\n\n<p id=\"abspara0015\">What are the prevalence, risk factors, clinical features, and outcomes of IAPA in critically ill patients?<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0020\">Study Design and Methods<\/h3>\n\n\n\n<p id=\"abspara0020\">Studies reporting IAPA were searched in the following databases: PubMed MEDLINE, CINAHL, Cochrane Library, Embase, Scopus, Cochrane Trials, and&nbsp;<a href=\"https:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">ClinicalTrials.gov<\/a>. We performed one-group meta-analysis on risk factors, clinical features, morbidity, and mortality using random effects models.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0025\">Results<\/h3>\n\n\n\n<p id=\"abspara0025\">We included 10 observational studies with 1,720 critically ill patients with influenza, resulting in an IAPA prevalence of 19.2%\u00a0(331 of 1,720). Patients who had undergone organ transplantation (OR, 4.8; 95%\u00a0CI, 1.7-13.8;\u00a0<em>I<\/em><sup><em>2<\/em><\/sup>\u00a0= 45%), harbored a hematogenous malignancy (OR, 2.5; 95%\u00a0CI, 1.5-4.1;\u00a0<em>I<\/em><sup><em>2<\/em><\/sup>\u00a0= 0%), were immunocompromised (OR, 2.2; 95%\u00a0CI, 1.6-3.1;\u00a0<em>I<\/em><sup><em>2<\/em><\/sup>\u00a0= 0%), and underwent prolonged corticosteroid use before admission (OR, 2.4; 95%\u00a0CI, 1.4-4.3;\u00a0<em>I<\/em><sup><em>2<\/em><\/sup>\u00a0= 51%) were found to be at a higher risk of IAPA developing. Commonly reported clinical and imaging features were not particularly associated with IAPA. However, IAPA was associated with more severe disease progression, a higher complication rate, and longer ICU stays and required more organ supports. Overall, IAPA was associated with a significantly elevated ICU mortality rate (OR, 2.6; 95%\u00a0CI, 1.8-3.8;\u00a0<em>I<\/em><sup><em>2<\/em><\/sup>\u00a0= 0%).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr1_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr2_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr3ae_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr3fi_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr4ae_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr4fj_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/ars.els-cdn.com\/content\/image\/1-s2.0-S0012369223055411-gr4kl_lrg.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0030\">Interpretation<\/h3>\n\n\n\n<p id=\"abspara0030\">IAPA is a common complication of severe influenza and is associated with increased mortality. Early diagnosis of IAPA and initiation of antifungal treatment are essential, and future research should focus on developing a clinical algorithm.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"sectitle0035\">Trial Registry<\/h3>\n\n\n\n<p id=\"abspara0035\">International Prospective Register of Systematic Reviews; No.: CRD42022284536; URL:&nbsp;<a href=\"https:\/\/www.crd.york.ac.uk\/prospero\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.crd.york.ac.uk\/prospero\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Chest Infections: Original Research Prevalence, Risk Fa [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25670"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25670"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25670\/revisions"}],"predecessor-version":[{"id":25994,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25670\/revisions\/25994"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25670"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25670"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25670"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}