Predictores de mortalidad en pacientes críticos con neumonía grave por coronavirus 2019 (COVID-19): un estudio observacional multicéntrico en Colombia

Abstract

Introduction

Patients on invasive mechanical ventilation (IMV) with COVID-19 have a high mortality. There is a lack of information on the factors associated with mortality in these patients with a hospital stay of less than 48 hours, which reflects the severity of the disease.

Objective

To identify the variables associated with mortality in patients admitted to the intensive care unit (ICU) in IMV with severe pneumonia due to COVID-19.

Materials and methods

Prospective study conducted from March 1 to July 30, 2021, in nine ICUs in the city of Medellín, Colombia. Adult patients who required IMV upon admission to the ICU, with a hospital stay of less than 48 hours, were included. The following variables were studied: personal history, laboratory tests, complications during the stay, and medical treatment. A multivariate analysis was performed in a Poisson regression model with robust errors.

Results

Of the 148 patients admitted to the study, 35.8% died. The risk factors related to mortality in the multivariate analysis were: older than 65 years [RR 2.15 (1.36 - 3.41)], continuing with IMV on day 7 of stay [RR 3.13 (1, 13 – 8.69)], and a history of chronic kidney disease [RR 2.09 (1.2 - 3.64)]. Patients with a C-reactive protein value greater than 10 mg/dL had lower mortality [RR 0.65 (0.44 – 0.95)].

Conclusions

Continuing IMV on day 7, being over 65 years of age, or chronic kidney disease were the risk factors associated with mortality.