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新型冠状病毒肺炎患者死亡的预测因素——一项系统综述

Predictors of mortality in patients with COVID-19-a systematic review.

作者信息

Mehraeen Esmaeil, Karimi Amirali, Barzegary Alireza, Vahedi Farzin, Afsahi Amir Masoud, Dadras Omid, Moradmand-Badie Banafsheh, Seyed Alinaghi Seyed Ahmad, Jahanfar Shayesteh

机构信息

Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.

School of medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Integr Med. 2020 Dec;40:101226. doi: 10.1016/j.eujim.2020.101226. Epub 2020 Oct 17.

Abstract

INTRODUCTION

In the current COVID-19 pandemic, disease diagnosis is essential for optimal management and timely isolation of infected cases in order to prevent further spread. The aim of this study was to systematically review the assessment of risk and model the predictors of mortality in COVID-19 patients.

METHODS

A systematic search was conducted of PubMed, Scopus, Embase, Google Scholar, and Web of Science databases. Variables associated with hospital mortality using bivariate analysis were included as potential independent predictors associated with mortality at the  < 0.05 levels.

RESULTS

We included 114 studies accounting for 310,494 patients from various parts of the world. For the purpose of this analysis, we set a cutoff point of 10% for the mortality percentages. High mortality rates were defined as higher than 10% of confirmed positive cases and were given a score of two, while low mortality (<10%) was assigned the score of one. We then analyzed the associations between 72 variables and the observed mortality rates. These variables included a large range of related variables such as demographics, signs and symptoms and related morbidities, vital signs, laboratory findings, imaging studies, underlying diseases, and the status of countries' income, based on the United Nation's classifications.

CONCLUSION

Findings suggest that older age, hypertension, and diabetes mellitus conferred a significant increased risk of mortality among patients with COVID-19. In the multivariate analysis, only diabetes mellitus demonstrated an independent relationship with increased mortality. Further studies are needed to ascertain the relationship between possible risk factors with COVID-19 mortality.

摘要

引言

在当前的新冠疫情大流行中,疾病诊断对于优化管理和及时隔离感染病例以防止进一步传播至关重要。本研究的目的是系统回顾新冠患者的风险评估并建立死亡率预测模型。

方法

对PubMed、Scopus、Embase、谷歌学术和科学网数据库进行了系统检索。使用双变量分析与医院死亡率相关的变量被纳入作为与死亡率相关的潜在独立预测因素,其P值<0.05。

结果

我们纳入了114项研究,涉及来自世界各地的310494名患者。为了本次分析的目的,我们将死亡率百分比的截断点设定为10%。高死亡率被定义为高于确诊阳性病例的10%,并给予2分,而低死亡率(<10%)则给予1分。然后我们分析了72个变量与观察到的死亡率之间的关联。这些变量包括一系列相关变量如人口统计学特征、体征和症状以及相关疾病、生命体征、实验室检查结果、影像学研究、基础疾病以及根据联合国分类的国家收入状况。

结论

研究结果表明,年龄较大、高血压和糖尿病会使新冠患者死亡风险显著增加。在多变量分析中只有糖尿病与死亡率增加存在独立关系。需要进一步研究以确定可能的风险因素与新冠死亡率之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b04a/7568488/ce29cafc02af/gr1_lrg.jpg

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