Francisco José Molina , Luz Elena Botero , Juan Pablo Isaza , Lucelly López , Marco Antonio González , Bladimir Alejandro Gil , Juan Luis Echeverri , Juan David Uribe , Victoria E. Ángel , Nelson Javier Fonseca , Sindy Sitton , Aurelio González , Juan Miguel Arias , Francisco Luis Zapata , Jhon Alexander Gallego , Ana Sofía Cortés , Daniel Giraldo , Andrea Mazo , Catalina Aguilar , Valentina Ruiz , Antoni Torres
{"title":"2019年重症冠状病毒肺炎（COVID-19）危重病人的死亡率预测因素：哥伦比亚的一项多中心观察研究。","authors":"Francisco José Molina , Luz Elena Botero , Juan Pablo Isaza , Lucelly López , Marco Antonio González , Bladimir Alejandro Gil , Juan Luis Echeverri , Juan David Uribe , Victoria E. Ángel , Nelson Javier Fonseca , Sindy Sitton , Aurelio González , Juan Miguel Arias , Francisco Luis Zapata , Jhon Alexander Gallego , Ana Sofía Cortés , Daniel Giraldo , Andrea Mazo , Catalina Aguilar , Valentina Ruiz , Antoni Torres","doi":"10.1016/j.acci.2023.12.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Objective</h3><p>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.</p></div><div><h3>Materials and methods</h3><p>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.</p></div><div><h3>Results</h3><p>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)].</p></div><div><h3>Conclusions</h3><p>Continuing IMV on day 7, being over 65 years of age, or chronic kidney disease were the risk factors associated with mortality.</p></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"24 2","pages":"Pages 114-123"},"PeriodicalIF":0.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictores de mortalidad en pacientes críticos con neumonía grave por coronavirus 2019 (COVID-19): un estudio observacional multicéntrico en Colombia\",\"authors\":\"Francisco José Molina , Luz Elena Botero , Juan Pablo Isaza , Lucelly López , Marco Antonio González , Bladimir Alejandro Gil , Juan Luis Echeverri , Juan David Uribe , Victoria E. Ángel , Nelson Javier Fonseca , Sindy Sitton , Aurelio González , Juan Miguel Arias , Francisco Luis Zapata , Jhon Alexander Gallego , Ana Sofía Cortés , Daniel Giraldo , Andrea Mazo , Catalina Aguilar , Valentina Ruiz , Antoni Torres\",\"doi\":\"10.1016/j.acci.2023.12.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Objective</h3><p>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.</p></div><div><h3>Materials and methods</h3><p>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.</p></div><div><h3>Results</h3><p>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)].</p></div><div><h3>Conclusions</h3><p>Continuing IMV on day 7, being over 65 years of age, or chronic kidney disease were the risk factors associated with mortality.</p></div>\",\"PeriodicalId\":100016,\"journal\":{\"name\":\"Acta Colombiana de Cuidado Intensivo\",\"volume\":\"24 2\",\"pages\":\"Pages 114-123\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Colombiana de Cuidado Intensivo\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0122726223001003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Colombiana de Cuidado Intensivo","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0122726223001003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
导言：接受有创机械通气（IMV）的 COVID-19 患者死亡率很高。目前还缺乏与这些住院时间少于 48 小时的患者死亡率相关的因素的信息，而这反映了疾病的严重程度。 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 methodsProspective study conducted from March 1 to July 30, 2021, in nine ICUs in the city Medellín, Colombia.研究对象包括入院时需要接受 IMV 治疗、住院时间少于 48 小时的成人患者。研究对象包括以下变量：个人病史、实验室检查、住院期间的并发症和治疗。研究采用带稳健误差的泊松回归模型进行多变量分析。在多变量分析中，与死亡率相关的风险因素包括：65 岁以上[RR 2.15 (1.36 - 3.41)]、住院第 7 天仍在接受 IMV 治疗[RR 3.13 (1, 13 - 8.69)]和慢性肾脏病史[RR 2.09 (1.2 - 3.64)]。C反应蛋白值大于 10 mg/dL 的患者死亡率较低[RR 0.65 (0.44 - 0.95)]。
Predictores de mortalidad en pacientes críticos con neumonía grave por coronavirus 2019 (COVID-19): un estudio observacional multicéntrico en Colombia
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.
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