非重症监护病房中与COVID-19死亡率相关的临床特征和危险因素

Q2 Medicine
Pierfrancesco Grima, Marcello Guido, Antonella Zizza
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引用次数: 3

摘要

在大流行期间,由新型冠状病毒(SARS-CoV-2)引起的2019冠状病毒病具有广泛的临床表现、病程和结局的特点。特别是,大多数有严重或危重症状的患者需要住院治疗。患者入院时的人口学和临床特征,以及先前存在的医疗状况,似乎影响了临床结果。研究非重症监护病房住院患者预后不良的预测因素。方法:对意大利南部一家医院传染病外科在疫情第一波期间收治的239例COVID-19确诊患者进行回顾性、单中心观察性研究。从患者的医疗记录中收集了人口统计学特征、基础疾病、临床、实验室和放射学结果。有关住院药物、入院天数和结果的信息也被考虑在内。采用推理统计分析来评估患者入院时和住院期间的特征与死亡之间的关系。结果:平均年龄67.8±15.8岁;137/239例(57.3%)患者为男性,176例(73.6%)患者至少有一种合并症。超过一半的患者(55.3%)患有高血压。住院时间16.5±9.9 d,病死率12.55%。在多变量logistic回归分析中,预测COVID-19患者死亡率的因素包括年龄(OR, 1.09;CI, 1.04-1.15),慢性肾脏疾病(OR, 4.04;CI, 1.38-11.85),需要高流量氧疗(OR, 18.23;CI, 5.06 - -65.64)。结论:死亡患者住院时间短于存活患者。年龄较大、既往存在慢性肾脏疾病和补充氧气需求是非重症监护病房COVID-19住院患者死亡率的独立预测因素。这些因素的确定使我们能够回顾性地更好地了解该疾病,并与连续的流行波进行比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics and risk factors associated with COVID-19 mortality in a non-Intensive Care Unit.

Introduction: The Coronavirus disease 2019 caused by a new Coronavirus (SARS-CoV-2) throughout the pandemic period has been characterised by a wide spectrum of clinical manifestations, courses, and outcomes. In particular, most patients with severe or critical symptoms re-quired hospitalization. The demographic and clinical characteristics of patients upon admission to the hospital, as well as pre-existing medical conditions, seem to have affected the clinical out-come. Predictive factors of inauspicious outcome in non-Intensive Care Unit hospitalized patients were investigated.

Methods: A retrospective, single-centre, observational study of 239 patients with confirmed COVID-19 disease admitted during the first waves of the pandemic to the Infectious Disease Operative Unit of a hospital in Southern Italy was conducted. Demographic characteristics, under-lying diseases, and clinical, laboratory, and radiological findings were collected from the patient's medical records. Information about in-hospital medications, days of admission, and out-come were also considered. Inferential statistical analysis was performed to evaluate the association between patients' characteristics upon hospital admission and during in-hospital length of stay and death.

Results: Mean age was 67.8 ± 15.8 years; 137/239 (57.3%) patients were males, and 176 (73.6%) had at least one comorbidity. More than half of patients (55.3%) suffered from hypertension. The length of stay in hospital was 16.5 ± 9.9 days and mortality rate of 12.55%. In multivariable logistic regression analysis, predictors of mortality of COVID-19 patients included age (OR, 1.09; CI, 1.04-1.15), Chronic Kidney Disease (OR, 4.04; CI, 1.38-11.85), and need of High Flow Oxygen therapy (OR, 18.23; CI, 5.06-65.64).

Conclusions: Patients who died in the hospital had shorted length of stay than that of the surviving patients. Older age, pre-existent chronic renal disease and need of supplemental oxygen represented independent predictors of mortality in patients hospitalized in non-Intensive Care Unit with COVID-19. The determination of these factors allows retrospectively a greater understanding of the disease also in comparison with the successive epidemic waves.

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来源期刊
Journal of Preventive Medicine and Hygiene
Journal of Preventive Medicine and Hygiene Medicine-Public Health, Environmental and Occupational Health
CiteScore
3.30
自引率
0.00%
发文量
50
期刊介绍: The journal is published on a four-monthly basis and covers the field of epidemiology and community health. The journal publishes original papers and proceedings of Symposia and/or Conferences which should be submitted in English. Papers are accepted on their originality and general interest. Ethical considerations will be taken into account.
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