The survival forecast in patient with pneumonia and immunity disorders on a background of the oncohematological disease

Borisova, I.S. and Kryachkova, L.V. (2018) The survival forecast in patient with pneumonia and immunity disorders on a background of the oncohematological disease. Одеський медичний журнал, 1(165). pp. 34-44. ISSN 2226-2008

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Abstract

The aim of the study: to determine the factors that cause the survival of patients with pneumonia, based on the study of complex, clinical and laboratory, anamnestic and immunological parameters of patients with pneumonia with immune disorders on the background of oncohematological pathology.Materials and methods. To solve the problem, a computer database of the results of the examination of 811 patients with lesions of the broncho-pulmonary system on the background of oncohematological pathology was created. The study was conducted in two stages in the haematological center "Multifunctional Clinical Hospital № 4", Dnipro, 2010-2016. The retrospective stage included the analysis of archival data of 535 cases of hospitalizations of patients with oncohematological pathology; prospective phase — a study of 276 cases of hospitalizations. Diagnosis of oncohematological diseases was determined according to generally accepted clinical and morphological criteria. The diagnosis of pneumonia was verified in accordance with the "Order of the Ministry of Health of Ukraine No. 128, March 19, 2007". We studied and analyzed the indices that characterizing the general condi¬tion of the patient; anamnestic information about the course of the main disease and peculiarities of the course of the broncho-pulmonary system disease in the dynamics. Features of infectious defeat of the bronchopulmonary system in the studied patients were studied regardless of the phase of the course of the underlying disease. The statistical processing of the research results was carried out using descriptive and analytical biostatistics methods implemented in software packages STATISTI-CA 6.1 (StatSoftInc., Serial No. AGAR909E415822FA); Microsoft Excel (Office Home Business 2KB4Y-6H9DB-BM47K-749PV-PG3KT). Median (Me) as a measure of the central tendency was used to describe the quantitative characteristics; interquartile scale ((25%, 75%) — 25 and 75 percentiles respectively, Q1 and Q3 - first and third quartiles) to describe the variation of attributes. In the statistical analysis of the results of the study, the non-parametric dispersion analysis of Kraskele-Wallis and the correlation analysis with the calculation of the Spirman rank correlation coefficients (с) were performed. Multiple comparisons were made with Bonferon and Holm. Methods for assessing survival of patients were used: analysis of lifetime tables and evaluation of Kaplan-Mayer's survival function with the construction of survival curves; logistic rank test with Yates correction for continuity; Cox proportional risk regression models were used too. Univariate and multiple analysis conducted; the ratio of risks was determined.The results of the study showed that the survival rate of patients with pneumonia on the back-ground of oncohematological pathology was determined by the factors that characterized the course of pneumonia, the course of oncological blood disease, indicators of immune reactivity.Independent predictors influencing the survival of patients with pneumonia on the background of oncohematological pathology determined the indicators: gram-negative pathogens, the number of erythrocytes and neutrophils, the number of courses of HT and the immunoregulatory index. The covari-ates of the favorable forecast of events are defined: the number of HT courses is less than 8; not determined in the patient gram-negative pathogens; the number of erythrocytes more than 2.01012/l; the immunoregulatory index is more than 1.09. Covariant of unfavorable forecast of events determined: number of chemotherapy courses 8 and more; the presence of gram-negative pathogens; the number of erythrocytes is less than 2.01012/l; the immunoregulatory index is less than 1.09. Analysis of survival of patients with pneumonia with immunity disorders on the background of oncohematological pathology with covariates of unfavorable development of events, proved that the survival rate during the month will be 30%, with a favorable prediction of the development of events - 96%.

Item Type: Article
Uncontrolled Keywords: pneumonia, survival of patients, immunity disorders, lethal outcome, factors of poor prognosis.
Subjects: Clinical medicine
Divisions: Faculty of Postgraduate Education > Department of Medical and Social Expertise and Rehabilitation FPE
Faculty of Postgraduate Education > Department of social medicine and health management
Depositing User: Оксана Мажуга
Date Deposited: 08 Jan 2019 12:14
Last Modified: 08 Jan 2019 12:14
URI: http://repo.dma.dp.ua/id/eprint/3696

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