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基于 Charlson 和 Elixhauser 合并症指数的严重和危重新冠肺炎预后模型。

Prognosis models for severe and critical COVID-19 based on the Charlson and Elixhauser comorbidity indices.

机构信息

Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Int J Med Sci. 2020 Aug 25;17(15):2257-2263. doi: 10.7150/ijms.50007. eCollection 2020.

Abstract

: Corona Virus Disease 2019 (COVID-19) has become a global pandemic. This study established prognostic scoring models based on comorbidities and other clinical information for severe and critical patients with COVID-19. : We retrospectively collected data from 51 patients diagnosed as severe or critical COVID-19 who were admitted between January 29, 2020, and February 18, 2020. The Charlson (CCI), Elixhauser (ECI), and age- and smoking-adjusted Charlson (ASCCI) and Elixhauser (ASECI) comorbidity indices were used to evaluate the patient outcomes. : The mean hospital length of stay (LOS) of the COVID-19 patients was 22.82 ± 12.32 days; 19 patients (37.3%) were hospitalized for more than 24 days. Multivariate analysis identified older age (OR 1.064, = 0.018, 95%CI 1.011-1.121) and smoking (OR 3.696, = 0.080, 95%CI 0.856-15.955) as positive predictors of a long LOS. There were significant trends for increasing hospital LOS with increasing CCI, ASCCI, and ASECI scores (OR 57.500, = 0.001, 95%CI 5.687-581.399; OR 71.500, = 0.001, 95%CI 5.689-898.642; and OR 19.556, = 0.001, 95%CI 3.315-115.372, respectively). The result was similar for the outcome of critical illness (OR 21.333, = 0.001, 95%CI 3.565-127.672; OR 13.000, = 0.009, 95%CI 1.921-87.990; OR 11.333, = 0.008, 95%CI 1.859-69.080, respectively). : This study established prognostic scoring models based on comorbidities and clinical information, which may help with the graded management of patients according to prognosis score and remind physicians to pay more attention to patients with high scores.

摘要

新冠病毒病 2019(COVID-19)已成为全球大流行疾病。本研究基于合并症和其他临床信息为 COVID-19 重症和危重症患者建立了预后评分模型。

我们回顾性收集了 2020 年 1 月 29 日至 2 月 18 日期间收治的 51 例确诊为重症或危重症 COVID-19 患者的数据。使用 Charlson(CCI)、Elixhauser(ECI)、年龄和吸烟调整的 Charlson(ASCCI)和 Elixhauser(ASECI)合并症指数评估患者结局。

COVID-19 患者的平均住院时间(LOS)为 22.82±12.32 天;19 例(37.3%)患者的住院时间超过 24 天。多变量分析确定年龄较大(OR 1.064, = 0.018,95%CI 1.011-1.121)和吸烟(OR 3.696, = 0.080,95%CI 0.856-15.955)是 LOS 延长的阳性预测因子。CCI、ASCCI 和 ASECI 评分越高,住院 LOS 越长,呈显著趋势(OR 57.500, = 0.001,95%CI 5.687-581.399;OR 71.500, = 0.001,95%CI 5.689-898.642;OR 19.556, = 0.001,95%CI 3.315-115.372)。危重症结局的结果也相似(OR 21.333, = 0.001,95%CI 3.565-127.672;OR 13.000, = 0.009,95%CI 1.921-87.990;OR 11.333, = 0.008,95%CI 1.859-69.080)。

本研究基于合并症和临床信息建立了预后评分模型,有助于根据预后评分对患者进行分级管理,并提醒医生注意评分较高的患者。

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