| アブストラクト | OBJECTIVES: To investigate short-term prognosis and prognostic factors for connective tissue disease-associated pneumocystis pneumonia (CTD-PCP) using the Japanese nationwide diagnosis procedure combination (DPC) inpatient database. METHODS: The present retrospective cohort study from April 2014 to March 2016 included data of patients with CTD-PCP extracted from the DPC database using the 10(th) revision of International Classification of Diseases and Injuries codes. RESULTS: In 15 901 766 cases registered from 1329 hospitals, 333 of 67 890 patients who were admitted with PCP were diagnosed with CTD-PCP and included in the study. The median age was 71.0 years, and 214 (64.3%), 80 (24.0%), and 29 (8.7%) patients received sulfamethoxazole/trimethoprim (ST) monotherapy and pentamidine-containing and atovaquone-containing therapy, respectively. There were 114 (34.2%) in-hospital deaths, and the 30-day and 60-day in-hospital survival rates after PCP treatment initiation were 66.0% and 53.7%, respectively. Older age (HR 1.06, 95% CI 1.03 to 1.08) and concomitant interstitial lung disease (ILD) (HR 1.65, 95% CI 1.12 to 2.42) were poor prognostic factors. Patients who completed PCP treatment with ST monotherapy had a significantly higher survival rate than those treated with those not treated with ST monotherapy (p=0.015; log-rank test). Pentamidine versus atovaquone as second-line therapy was significantly higher with atovaquone (p=0.012; log-rank test). CONCLUSION: Older age and concomitant ILD were poor prognostic factors for CTD-PCP. ST was a reasonable first-line therapy in patients with CTD-PCP, and patients with inadequate response to ST treated with atovaquone tended to have a better prognosis than those treated with pentamidine. |
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| ジャーナル名 | RMD open |
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| Pubmed追加日 | 2021/3/11 |
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| 投稿者 | Ishikawa, Yuichi; Nakano, Kazuhisa; Tokutsu, Kei; Miyata, Hiroko; Fujino, Yoshihisa; Matsuda, Shinya; Tanaka, Yoshiya |
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| 組織名 | The First Department of Internal Medicine, University of Occupational and;Environmental Health, Japan, Kitakyushu, Japan.;Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan.;Sato Clinic, Tokyo, Japan.;Department of Preventive Medicine and Community Health, University of;Occupational and Environmental Health Japan, Kitakyushu, Fukuoka, Japan.;Department of Environmental Epidemiology, University of Occupational and;Environmental Health Japan, Kitakyushu, Japan.;Environmental Health, Japan, Kitakyushu, Japan tanaka@med.uoeh-u.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33688083/ |
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