Burn Edward, Sena Anthony G, Prats-Uribe Albert, Spotnitz Matthew, DuVall Scott, Lynch Kristine E, Matheny Michael E, Nyberg Fredrik, Ahmed Waheed-Ul-Rahman, Alser Osaid, Alghoul Heba, Alshammari Thamir, Zhang Lin, Casajust Paula, Areia Carlos, Shah Karishma, Reich Christian, Blacketer Clair, Andryc Alan, Fortin Stephen, Natarajan Karthik, Gong Mengchun, Golozar Asieh, Morales Daniel, Rijnbeek Peter, Subbian Vignesh, Roel Elena, Recalde Martina, Lane Jennifer C E, Vizcaya David, Posada Jose D, Shah Nigam H, Jonnagaddala Jitendra, Lai Lana Yin Hui, Avilés-Jurado Francesc Xavier, Hripcsak George, Suchard Marc A, Ranzani Otavio T, Ryan Patrick, Prieto-Alhambra Daniel, Kostka Kristin, Duarte-Salles Talita
Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
Centre for Statistics in Medicine, NDORMS, University of Oxford.
medRxiv. 2021 Feb 12:2020.11.25.20229088. doi: 10.1101/2020.11.25.20229088.
To estimate the proportion of patients hospitalized with COVID-19 who undergo dialysis, tracheostomy, and extracorporeal membrane oxygenation (ECMO).
A network cohort study.
Seven databases from the United States containing routinely-collected patient data: HealthVerity, Premier, IQVIA Hospital CDM, IQVIA Open Claims, Optum EHR, Optum SES, and VA-OMOP.
Patients hospitalized with a clinical diagnosis or a positive test result for COVID-19.
Dialysis, tracheostomy, and ECMO.
842,928 patients hospitalized with COVID-19 were included (22,887 from HealthVerity, 77,853 from IQVIA Hospital CDM, 533,997 from IQVIA Open Claims, 36,717 from Optum EHR, 4,336 from OPTUM SES, 156,187 from Premier, and 10,951 from VA-OMOP). Across the six databases, 35,192 (4.17% [95% CI: 4.13% to 4.22%]) patients received dialysis, 6,950 (0.82% [0.81% to 0.84%]) had a tracheostomy, and 1,568 (0.19% [95% CI: 0.18% to 0.20%]) patients underwent ECMO over the 30 days following hospitalization. Use of ECMO was more common among patients who were younger, male, and with fewer comorbidities. Tracheostomy was broadly used for a similar proportion of patients regardless of age, sex, or comorbidity. While dialysis was generally used for a similar proportion among younger and older patients, it was more frequent among male patients and among those with chronic kidney disease.
Use of dialysis among those hospitalized with COVID-19 is high at around 4%. Although less than one percent of patients undergo tracheostomy and ECMO, the absolute numbers of patients who have undergone these interventions is substantial.
评估因新冠肺炎住院并接受透析、气管切开术和体外膜肺氧合（ECMO）治疗的患者比例。
一项网络队列研究。
来自美国的七个数据库，包含常规收集的患者数据：HealthVerity、Premier、IQVIA医院临床数据管理系统（CDM）、IQVIA公开理赔数据库、Optum电子健康记录（EHR）、Optum SES和退伍军人事务部（VA）的观察医疗结果合作伙伴（OMOP）数据库。
因新冠肺炎临床诊断或检测结果呈阳性而住院的患者。
透析、气管切开术和ECMO。
纳入842,928例因新冠肺炎住院的患者（HealthVerity数据库22,887例、IQVIA医院CDM数据库77,853例、IQVIA公开理赔数据库533,997例、Optum EHR数据库36,717例、OPTUM SES数据库4,336例、Premier数据库156,187例、VA-OMOP数据库10,951例）。在这六个数据库中，35,192例（4.17%[95%CI：4.13%至4.22%]）患者接受了透析，6,950例（0.82%[0.81%至0.84%]）进行了气管切开术，1,568例（0.19%[95%CI：0.18%至0.20%]）患者在住院后的30天内接受了ECMO治疗。ECMO在年龄较小、男性且合并症较少的患者中使用更为常见。气管切开术在不同年龄、性别或合并症的患者中使用比例大致相似。虽然透析在年轻患者和老年患者中的使用比例总体相似，但在男性患者和患有慢性肾病的患者中更为频繁。
因新冠肺炎住院的患者中透析使用率约为4%，较高。虽然接受气管切开术和ECMO的患者不到1%，但接受这些干预措施的患者绝对数量相当可观。
