| Title |
Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome
|
|---|---|
| Published in |
Intensive Care Medicine, March 2016
|
| DOI | 10.1007/s00134-015-4071-z |
| Pubmed ID | |
| Authors |
David S. Y. Ong, Cristian Spitoni, Peter M. C. Klein Klouwenberg, Frans M. Verduyn Lunel, Jos F. Frencken, Marcus J. Schultz, Tom van der Poll, Jozef Kesecioglu, Marc J. M. Bonten, Olaf L. Cremer |
| Abstract |
Cytomegalovirus (CMV) reactivation occurs frequently in patients with the acute respiratory distress syndrome (ARDS) and has been associated with increased mortality. However, it remains unknown whether this association represents an independent risk for poor outcome. We aimed to estimate the attributable effect of CMV reactivation on mortality in immunocompetent ARDS patients. We prospectively studied immunocompetent ARDS patients who tested seropositive for CMV and remained mechanically ventilated beyond day 4 in two tertiary intensive care units in the Netherlands from 2011 to 2013. CMV loads were determined in plasma weekly. Competing risks Cox regression was used with CMV reactivation status as a time-dependent exposure variable. Subsequently, in sensitivity analyses we adjusted for the evolution of disease severity until onset of reactivation using marginal structural modeling. Of 399 ARDS patients, 271 (68 %) were CMV seropositive and reactivation occurred in 74 (27 %) of them. After adjustment for confounding and competing risks, CMV reactivation was associated with overall increased ICU mortality (adjusted subdistribution hazard ratio (SHR) 2.74, 95 % CI 1.51-4.97), which resulted from the joint action of trends toward an increased mortality rate (direct effect; cause specific hazard ratio (HR) 1.58, 95 % CI 0.86-2.90) and a reduced successful weaning rate (indirect effect; cause specific HR 0.83, 95 % CI 0.58-1.18). These associations remained in sensitivity analyses. The population-attributable fraction of ICU mortality was 23 % (95 % CI 6-41) by day 30 (risk difference 4.4, 95 % CI 1.1-7.9). CMV reactivation is independently associated with increased case fatality in immunocompetent ARDS patients who are CMV seropositive. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 17% |
| Belgium | 1 | 17% |
| United States | 1 | 17% |
| Unknown | 3 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Scientists | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 67 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | 1% |
| Unknown | 66 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 15% |
| Other | 8 | 12% |
| Student > Bachelor | 6 | 9% |
| Student > Master | 6 | 9% |
| Student > Postgraduate | 5 | 7% |
| Other | 12 | 18% |
| Unknown | 20 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 31 | 46% |
| Immunology and Microbiology | 3 | 4% |
| Agricultural and Biological Sciences | 3 | 4% |
| Nursing and Health Professions | 2 | 3% |
| Veterinary Science and Veterinary Medicine | 1 | 1% |
| Other | 2 | 3% |
| Unknown | 25 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 October 2020.
All research outputs
#2,341,117
of 22,829,683 outputs
Outputs from Intensive Care Medicine
#1,645
of 4,986 outputs
Outputs of similar age
#39,420
of 298,352 outputs
Outputs of similar age from Intensive Care Medicine
#22
of 126 outputs
Altmetric has tracked 22,829,683 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,986 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 27.1. This one has gotten more attention than average, scoring higher than 66% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 298,352 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 126 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.