分析儿童和青少年因 COVID-19 而入住重症监护室的相关因素:多层次模型的应用

L. C. L. Damascena, Aline Roseane Queiroz de Paiva Faria, Nyellisonn Nando Nóbrega de Lucena, Ana Hermínia Andrade e Silva, Talita Tavares Alves de Almeida, Diana de Fátima Alves Pinto, H. F. Coêlho, Ana Maria Gondim Valença
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引用次数: 0

摘要

ABSTRACT Objective To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19。方法 这是一项回顾性队列研究,使用的是 2020 年 4 月至 2021 年 7 月期间帕拉伊巴州报告的 COVID-19 住院儿童和青少年(0 至 18 岁)的二手数据,共计 486 条记录。研究采用描述性分析、逻辑回归和多层次回归,显著性水平为 5%。结果 根据无层次的逻辑回归,男性患者(OR = 1.98;95%CI 1.18 - 3.32)、呼吸困难患者(OR = 2.43;95%CI 1.29 - 4.56)、呼吸困难患者(OR = 3.57;95%CI 1.77 - 7.18)和居住在大城市的患者(OR = 2.70;95%CI 1.07 - 6.77)入住重症监护室的几率增加。据观察,随着年龄的增加(OR = 0.94;95%CI = 0.90 - 0.97)、出现咳嗽(OR = 0.32;95%CI 0.18 - 0.59)或发烧(OR = 0.42;95%CI 0.23 - 0.74)以及基尼指数的增加(OR = 0.003;95%CI 0.000 - 0.243),需要重症监护的可能性降低。根据多层次分析,男性患者入住重症监护室的几率增加(OR = 1.70;95%CI = 1.68-1.71),且随着每 10 万居民中城市人口数量的增加而增加(OR = 1.01;95%CI=1.01-1.03);此外,混血儿相对于非棕色皮肤患者(OR=0.981;95%CI=0.97-0.99)和基尼指数增加(OR=0.02;95%CI=0.02-0.02)时,入住重症监护室的几率降低。结论 采用多层次回归模型可以更好地估计患者特征和社会环境对感染 SARS-CoV-2 的儿童和青少年重症监护需求的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of factors associated with admission to the intensive care unit of children and adolescents with COVID-19: application of a multilevel model
ABSTRACT Objective To identify factors associated with hospitalization in the intensive care unit in children and adolescents with COVID-19. Methods This was a retrospective cohort study using secondary data of hospitalized children and adolescents (zero to 18 years old) with COVID-19 reported in Paraíba from April 2020 to July 2021, totaling 486 records. Descriptive analysis, logistic regression and multilevel regression were performed, utilizing a significance level of 5%. Results According to logistic regression without hierarchical levels, there was an increased chance of admission to the intensive care unit for male patients (OR = 1.98; 95%CI 1.18 - 3.32), patients with respiratory distress (OR = 2.43; 95%CI 1.29 - 4.56), patients with dyspnea (OR = 3.57; 95%CI 1.77 - 7.18) and patients living in large cities (OR = 2.70; 95%CI 1.07 - 6.77). The likelihood of requiring intensive care was observed to decrease with increasing age (OR = 0.94; 95%CI = 0.90 - 0.97), the presence of cough (OR = 0.32; 95%CI 0.18 - 0.59) or fever (OR = 0.42; 95%CI 0.23 - 0.74) and increasing Gini index (OR = 0.003; 95%CI 0.000 - 0.243). According to the multilevel analysis, the odds of admission to the intensive care unit increased in male patients (OR = 1.70; 95%CI = 1.68-1.71) and with increasing population size of the municipality per 100,000 inhabitants (OR = 1.01; 95%CI 1.01-1.03); additionally, the odds of admission to the intensive care unit decreased for mixed-race versus non-brown-skinned patients (OR = 0.981; 95%CI 0.97 - 0.99) and increasing Gini index (OR = 0.02; 95%CI 0.02 - 0.02). Conclusion The effects of patient characteristics and social context on the need for intensive care in children and adolescents with SARS-CoV-2 infection were better estimated with the inclusion of a multilevel regression model.
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