Irina Ciumanghel, Iulian Buzincu, Adi Ionut Ciumanghel, Eliza Barbuta, Diana Cimpoesu
{"title":"Covid-19和急性肢体缺血患者的流行病学、临床特征和预后因素--一项单中心研究。","authors":"Irina Ciumanghel, Iulian Buzincu, Adi Ionut Ciumanghel, Eliza Barbuta, Diana Cimpoesu","doi":"10.1177/17085381241236932","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period.</p><p><strong>Methods: </strong>This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1<sup>st</sup>, 2020 and February 28<sup>th</sup>, 2022 with ALI and Covid-19.</p><p><strong>Results: </strong>During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1.14% of all with Covid-19) presented ALI. The mean age was 70.9 ± 10.23 and 67.3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22.6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3.3; 68, <i>p</i> < .01), lymphopenia 96% versus 70% (OR 10.2, CI 1.30; 80.9, <i>p</i> < .01), a NLR over 9.77% versus 30% (OR 7.5, CI 2.6; 21.4, <i>p</i> < .01), acidosis 65% versus 33% (OR 3.8, CI 1.4; 9.7, <i>p</i> < .01), abnormal AST, 69% versus 29% (OR 5.4, CI 2; 14.5, <i>p</i> < .01) and secondary amputation, 38.5 versus 11.1% (OR 5, CI 1.7; 14.7, <i>p</i> < 0.1). Overall, the mortality rate was 26.5%.</p><p><strong>Conclusion: </strong>The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1.14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"50-57"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epidemiology, clinical features and prognostic factors in patients with Covid-19 and acute limb ischaemia - A single center study.\",\"authors\":\"Irina Ciumanghel, Iulian Buzincu, Adi Ionut Ciumanghel, Eliza Barbuta, Diana Cimpoesu\",\"doi\":\"10.1177/17085381241236932\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period.</p><p><strong>Methods: </strong>This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1<sup>st</sup>, 2020 and February 28<sup>th</sup>, 2022 with ALI and Covid-19.</p><p><strong>Results: </strong>During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1.14% of all with Covid-19) presented ALI. The mean age was 70.9 ± 10.23 and 67.3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22.6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3.3; 68, <i>p</i> < .01), lymphopenia 96% versus 70% (OR 10.2, CI 1.30; 80.9, <i>p</i> < .01), a NLR over 9.77% versus 30% (OR 7.5, CI 2.6; 21.4, <i>p</i> < .01), acidosis 65% versus 33% (OR 3.8, CI 1.4; 9.7, <i>p</i> < .01), abnormal AST, 69% versus 29% (OR 5.4, CI 2; 14.5, <i>p</i> < .01) and secondary amputation, 38.5 versus 11.1% (OR 5, CI 1.7; 14.7, <i>p</i> < 0.1). Overall, the mortality rate was 26.5%.</p><p><strong>Conclusion: </strong>The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1.14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.</p>\",\"PeriodicalId\":23549,\"journal\":{\"name\":\"Vascular\",\"volume\":\" \",\"pages\":\"50-57\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vascular\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17085381241236932\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17085381241236932","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/28 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Epidemiology, clinical features and prognostic factors in patients with Covid-19 and acute limb ischaemia - A single center study.
Background: The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period.
Methods: This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1st, 2020 and February 28th, 2022 with ALI and Covid-19.
Results: During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1.14% of all with Covid-19) presented ALI. The mean age was 70.9 ± 10.23 and 67.3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22.6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3.3; 68, p < .01), lymphopenia 96% versus 70% (OR 10.2, CI 1.30; 80.9, p < .01), a NLR over 9.77% versus 30% (OR 7.5, CI 2.6; 21.4, p < .01), acidosis 65% versus 33% (OR 3.8, CI 1.4; 9.7, p < .01), abnormal AST, 69% versus 29% (OR 5.4, CI 2; 14.5, p < .01) and secondary amputation, 38.5 versus 11.1% (OR 5, CI 1.7; 14.7, p < 0.1). Overall, the mortality rate was 26.5%.
Conclusion: The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1.14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.
期刊介绍：
Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.
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