Outcomes in HCAP vs CAP
HCAP vs CAP の評価
HCAP was associated with a statistically significant and consistent increase in mortality across all studies (n = 23 studies, 20 181 participants; OR, 2.44, 95% CI, 2.20–2.69; P < .0001; I2 = 0%).
全研究にわたってHCAPは統計的に有意な死亡率の一貫した増加と関係があった
(n = 23 研究, 20 181 参加者; オッズ比, 2.44, 95% CI, 2.20–2.69; P < 0.0001; I2 = 0%).
This was also evident in prospective studies
(n = 7, 8283 participants; OR, 2.52, 95% CI, 2.15–2.95; I2 = 0%).
これは前向き研究でも明らかだった
(n = 7, 8283 参加者; オッズ比, 2.52, 95% CI, 2.15–2.95; I2 = 0%).
Evaluating studies using in-hospital or
30-day mortality separately did not impact these findings.
院内または30日間死亡率を用いた研究の評価は
個別にはこれらの結果に影響を与えなかった
Because nearly all studies reported a higher mean age and a higher frequency of comorbidities in the HCAP group compared with the CAP groups,
the analysis was limited to those studies that provided adjusted ORs after accounting for age and comorbid illnesses.
なぜならほとんど全ての研究はCAP群と比較してHCAP群において平均年齢がより高くかつ合併症の頻度がより高い
ことを報告していたため、解析は年齢と並存疾患を考慮後の調整オッズ比を提示した研究に限定された
There were only 4 studies with available ad justed data for meta-analysis [3, 6, 25, 27].
メタ解析のための調整されたデータを伴う研究は4研究のみがあった
This showed no significant increase in mortality associated with HCAP
(OR, 1.20; 95% CI, 0.85–1.70; P = .30).
これではHCAPに関係した死亡率の有意な増加はみられなかった
(OR, 1.20; 95% CI, 0.85–1.70; P =0 .30).
There was significant heterogeneity
in this analysis, which was resolved by excluding the study by Kollef et al, which was limited to culture-positive cases [3].
この解析では有意な異質性があり、それは、
培養陽性ケースに限定されたKollef et al,らの研究を除外することで解決した
Excluding this study,
the OR was 0.98 (95% CI, 0.70–1.36; P = .90) with no heterogeneity (I2 = 0%).
この研究を除外すると、オッズ比は
0.98 (95% CI, 0.70–1.36; P =0 .90) で
異質性は (I2 = 0%).
The unadjusted and adjusted ORs are shown in Figure 3.
非調整と調整オッズ比はFigure3に示す
In the crude pooled analysis, HCAP was associated with a statistically significant increase in risk of ICU admission
(n = 12, 15 201 participants; OR, 1.39, 95% CI, 1.08–1.78; P = .01; I2 = 78%).
生のプール解析ではHCAPはICU入院リスクにおいて
統計的に有意な増加と関係があった
(n = 12, 15 201 参加者; OR, 1.39, 95% CI, 1.08–1.78; P = 0.01; I2 = 78%).
Limiting the analysis to prospective studies identified no increase in ICU admission
(n = 4 studies, 5821 pa- tients; OR, 0.99, 95% CI, 0.45–2.17; P = .98; I2 = 78%).
前向き研究に限定すると、ICU入院において増加は
検出されなかった
(n = 4 研究, 5821 参加者; OR, 0.99, 95% CI, 0.45–2.17; P =0 .98; I2 = 78%).
ICU admission criteria vary significantly between North America, Europe, and Asia.
ICU入院の基準は 北米、ヨーロッパとアジアの間で
大きく違いがある
This was reflected in the results, which showed an increased ICU admission rate in HCAP studies from North America
(OR, 1.55; 95% CI, 1.35–1.78; P < .0001; I2 = 0%)
but no increase in studies from Asia (OR, 1.47, 95% CI, 0.92–2.36; P = .1; I2 = 78%) or Europe (OR, 1.06, 95% CI, 0.56–2.01; P = .90, I2 = 88%).
このことは結果に反映した
北米のHCAP研究ではICU入院率の増加を示し
(OR, 1.55; 95% CI, 1.35–1.78; P < 0.0001; I2 = 0%)
がしかしアジアの研究
(OR, 1.47, 95% CI, 0.92–2.36; P = 0.1; I2 = 78%)
またはヨーロッパの研究の解析
(OR, 1.06, 95% CI, 0.56–2.01; P =0 .90, I2 = 88%).では示さなかった
HCAP vs CAP の評価
HCAP was associated with a statistically significant and consistent increase in mortality across all studies (n = 23 studies, 20 181 participants; OR, 2.44, 95% CI, 2.20–2.69; P < .0001; I2 = 0%).
全研究にわたってHCAPは統計的に有意な死亡率の一貫した増加と関係があった
(n = 23 研究, 20 181 参加者; オッズ比, 2.44, 95% CI, 2.20–2.69; P < 0.0001; I2 = 0%).
This was also evident in prospective studies
(n = 7, 8283 participants; OR, 2.52, 95% CI, 2.15–2.95; I2 = 0%).
これは前向き研究でも明らかだった
(n = 7, 8283 参加者; オッズ比, 2.52, 95% CI, 2.15–2.95; I2 = 0%).
Evaluating studies using in-hospital or
30-day mortality separately did not impact these findings.
院内または30日間死亡率を用いた研究の評価は
個別にはこれらの結果に影響を与えなかった
Because nearly all studies reported a higher mean age and a higher frequency of comorbidities in the HCAP group compared with the CAP groups,
the analysis was limited to those studies that provided adjusted ORs after accounting for age and comorbid illnesses.
なぜならほとんど全ての研究はCAP群と比較してHCAP群において平均年齢がより高くかつ合併症の頻度がより高い
ことを報告していたため、解析は年齢と並存疾患を考慮後の調整オッズ比を提示した研究に限定された
There were only 4 studies with available ad justed data for meta-analysis [3, 6, 25, 27].
メタ解析のための調整されたデータを伴う研究は4研究のみがあった
This showed no significant increase in mortality associated with HCAP
(OR, 1.20; 95% CI, 0.85–1.70; P = .30).
これではHCAPに関係した死亡率の有意な増加はみられなかった
(OR, 1.20; 95% CI, 0.85–1.70; P =0 .30).
There was significant heterogeneity
in this analysis, which was resolved by excluding the study by Kollef et al, which was limited to culture-positive cases [3].
この解析では有意な異質性があり、それは、
培養陽性ケースに限定されたKollef et al,らの研究を除外することで解決した
Excluding this study,
the OR was 0.98 (95% CI, 0.70–1.36; P = .90) with no heterogeneity (I2 = 0%).
この研究を除外すると、オッズ比は
0.98 (95% CI, 0.70–1.36; P =0 .90) で
異質性は (I2 = 0%).
The unadjusted and adjusted ORs are shown in Figure 3.
非調整と調整オッズ比はFigure3に示す
In the crude pooled analysis, HCAP was associated with a statistically significant increase in risk of ICU admission
(n = 12, 15 201 participants; OR, 1.39, 95% CI, 1.08–1.78; P = .01; I2 = 78%).
生のプール解析ではHCAPはICU入院リスクにおいて
統計的に有意な増加と関係があった
(n = 12, 15 201 参加者; OR, 1.39, 95% CI, 1.08–1.78; P = 0.01; I2 = 78%).
Limiting the analysis to prospective studies identified no increase in ICU admission
(n = 4 studies, 5821 pa- tients; OR, 0.99, 95% CI, 0.45–2.17; P = .98; I2 = 78%).
前向き研究に限定すると、ICU入院において増加は
検出されなかった
(n = 4 研究, 5821 参加者; OR, 0.99, 95% CI, 0.45–2.17; P =0 .98; I2 = 78%).
ICU admission criteria vary significantly between North America, Europe, and Asia.
ICU入院の基準は 北米、ヨーロッパとアジアの間で
大きく違いがある
This was reflected in the results, which showed an increased ICU admission rate in HCAP studies from North America
(OR, 1.55; 95% CI, 1.35–1.78; P < .0001; I2 = 0%)
but no increase in studies from Asia (OR, 1.47, 95% CI, 0.92–2.36; P = .1; I2 = 78%) or Europe (OR, 1.06, 95% CI, 0.56–2.01; P = .90, I2 = 88%).
このことは結果に反映した
北米のHCAP研究ではICU入院率の増加を示し
(OR, 1.55; 95% CI, 1.35–1.78; P < 0.0001; I2 = 0%)
がしかしアジアの研究
(OR, 1.47, 95% CI, 0.92–2.36; P = 0.1; I2 = 78%)
またはヨーロッパの研究の解析
(OR, 1.06, 95% CI, 0.56–2.01; P =0 .90, I2 = 88%).では示さなかった