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人口统计学、临床和入院时实验室因素与住院 COVID-19 患者死亡的相关性:一项回顾性观察研究。

Sociodemographic, clinical and laboratory factors on admission associated with COVID-19 mortality in hospitalized patients: A retrospective observational study.

机构信息

Preventive Medicine and Public Health Service, Hospital Universitario Clínico San Cecilio, Granada, Spain.

Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.

出版信息

PLoS One. 2020 Jun 25;15(6):e0235107. doi: 10.1371/journal.pone.0235107. eCollection 2020.

Abstract

BACKGROUND

To identify and quantify associations between baseline characteristics on hospital admission and mortality in patients with COVID-19 at a tertiary hospital in Spain.

METHODS AND FINDINGS

This retrospective case series included 238 patients hospitalized for COVID-19 at Hospital Universitario Clínico San Cecilio (Granada, Spain) who were discharged or who died. Electronic medical records were reviewed to obtain information on sex, age, personal antecedents, clinical features, findings on physical examination, and laboratory results for each patient. Associations between mortality and baseline characteristics were estimated as hazard ratios (HR) calculated with Cox regression models. Series mortality was 25.6%. Among patients with dependence for basic activities of daily living, 78.7% died, and among patients residing in retirement homes, 80.8% died. The variables most clearly associated with a greater hazard of death were age (3% HR increase per 1-year increase in age; 95%CI 1-6), diabetes mellitus (HR 2.42, 95%CI 1.43-4.09), SatO2/FiO2 ratio (43% HR reduction per 1-point increase; 95%CI 23-57), SOFA score (19% HR increase per 1-point increase, 95%CI 5-34) and CURB-65 score (76% HR increase per 1-point increase, 95%CI 23-143).

CONCLUSIONS

The patients residing in retirement homes showed great vulnerability. The main baseline factors that were independently associated with mortality in patients hospitalized for COVID-19 were older age, diabetes mellitus, low SatO2/FiO2 ratio, and high SOFA and CURB-65 scores.

摘要

背景

本研究旨在确定并量化西班牙一家三级医院中 COVID-19 患者入院时的基线特征与死亡率之间的关联。

方法和发现

本回顾性病例系列纳入了在西班牙格拉纳达大学临床圣塞西莉亚医院(Hospital Universitario Clínico San Cecilio)因 COVID-19 住院且出院或死亡的 238 例患者。对电子病历进行了审查,以获取每位患者的性别、年龄、个人既往史、临床特征、体格检查结果和实验室结果等信息。使用 Cox 回归模型计算风险比(hazard ratio,HR),以评估死亡率与基线特征之间的关联。本研究的系列死亡率为 25.6%。在需要依靠他人才能完成日常生活基本活动的患者中,有 78.7%的患者死亡;在居住在养老院的患者中,有 80.8%的患者死亡。与死亡风险增加相关性最强的变量包括年龄(每增加 1 岁,死亡风险增加 3%;95%置信区间为 1-6)、糖尿病(HR 2.42,95%置信区间为 1.43-4.09)、SatO2/FiO2 比值(每增加 1 点,死亡风险降低 43%;95%置信区间为 23-57)、SOFA 评分(每增加 1 分,死亡风险增加 19%;95%置信区间为 5-34)和 CURB-65 评分(每增加 1 分,死亡风险增加 76%;95%置信区间为 23-143)。

结论

居住在养老院的患者表现出了极大的脆弱性。与 COVID-19 住院患者死亡率独立相关的主要基线因素是年龄较大、糖尿病、低 SatO2/FiO2 比值以及高 SOFA 和 CURB-65 评分。

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