Risk factors for invasive fungal disease in critically ill adult patients a systematic review 英文参考文献.docVIP

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Risk factors for invasive fungal disease in critically ill adult patients a systematic review 英文参考文献.doc

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Risk factors for invasive fungal disease in critically ill adult patients a systematic review 英文参考文献

Muskettetal.CriticalCare2011,15:R287 /content/15/6/R287 RESEARCH OpenAccess Riskfactorsforinvasivefungaldiseaseincritically illadultpatients:asystematicreview HannahMuskett1,JasonShahin1,GavinEyres1,SheilaHarvey1,KathyRowan1,2 andDavidHarrison1,3* Abstract Introduction:Over5,000casesofinvasiveCandidaspeciesinfectionsoccurintheUnitedKingdomeachyear,and around40%ofthesecasesoccurincriticalcareunits.Invasivefungaldisease(IFD)incriticallyillpatientsis associatedwithincreasedmorbidityandmortalityatacosttoboththeindividualandtheNationalHealthService. Inthispaper,wereporttheresultsofasystematicreviewperformedtoidentifyandsummarisetheimportantrisk factorsderivedfrompublishedmultivariableanalyses,riskpredictionmodelsandclinicaldecisionrulesforIFDin criticallyilladultpatientstoinformtheprimarydatacollectionfortheFungalInfectionRiskEvaluationStudy. Methods:Aninternetsearchwasperformedtoidentifyarticleswhichinvestigatedriskfactors,riskprediction modelsorclinicaldecisionsrulesforIFDincriticallyilladultpatients.Eligiblearticleswereidentifiedinastaged processandwereassessedbytwoinvestigatorsindependently.Themethodologicalqualityofthereportingofthe eligiblearticleswasassessedusingasetofquestionsaddressingbothgeneralandstatisticalmethodologies. Results:Thirteenarticlesmettheinclusioncriteria,ofwhicheightarticlesexaminedriskfactors,fourdevelopeda riskpredictionmodelorclinicaldecisionruleandoneevaluatedaclinicaldecisionrule.Studiesvariedintermsof objectives,riskfactors,definitionsandoutcomes.Thefollowingriskfactorswerefoundinmultiplestudiestobe significantlyassociatedwithIFD:surgery,totalparenteralnutrition,fungalcolonisation,renalreplacementtherapy, infectionand/orsepsis,mechanicalventilation,diabetes,andAcutePhysiologyandChronicHealthEvaluationII (APACHEII)orAPACHEIIIscore.Severalotherriskfactorswerealsofoundtobestatisticallysignificantinsingle studiesonly.Riskfactorselectionprocessandmodellingstrategyalsovariedacrossstudies,andsamplesizeswere inadequateforobtainingreliablees