Division of Geriatrics, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
Department of Public Health, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey
Turk J Med Sci. 2021 Apr 30;51(2):454-463. doi: 10.3906/sag-2008-91.
BACKGROUND/AIM: We aimed to investigate the factors affecting the mortality of patients aged 65 years or older who were hospitalized with the diagnosis of new coronavirus pneumonia (COVID-19).
This is a retrospective study of patients 65 years old or older with COVID-19 who were hospitalized in İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty Hospital, between March 11 and May 28, 2020. Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records. We used univariate and multivariate logistic regression methods to explore the risk factors for in-hospital death.
A total of 218 patients (112 men, 106 women) were included, of whom 166 were discharged and 52 died in hospital. With univariate analysis, various clinical features and laboratory variables were found to be significantly different (i.e. P < 0.05). In multivariate logistic regression analysis the following were independently associated with mortality: present malignancy [odds ratio (OR) = 4.817, 95% confidence interval (CI) = 1.107–20.958, P: 0.036]; dyspnea (OR = 4.652, 95% CI = 1.473–14.688, P: 0.009); neutrophil/lymphocyte ratio (NLR; OR = 1.097, 95% CI = 1.012–1.188, P: 0.025); the highest values of C-reactive protein (CRP; OR = 1.006, 95% CI = 1.000–1.012, P: 0.049), lactate dehydrogenase (LDH; OR = 1.002, 95% CI = 1.001–1.004, P: 0.003), and creatinine levels (OR = 1.497, 95% CI = 1.126–1.990, P: 0.006); oxygen saturation (SpO2) values on admission (OR = 0.897, 95% CI = 0.811–0.993, P: 0.036); and azithromycin use (OR = 0.239, 95% CI = 0.065–0.874, P: 0.031).
The presence of malignancy; symptoms of dyspnea; high NLR; highest CRP, LDH, and creatinine levels; and low SpO2 on admission predicted mortality. On the other hand, azithromycin use was found to be protective against mortality. Knowing the causes predicting mortality will be important to treat future cases more successfully.
背景/目的：我们旨在研究诊断为新型冠状病毒肺炎（COVID-19）的 65 岁及以上住院患者死亡的影响因素。
这是一项对 2020 年 3 月 11 日至 5 月 28 日在伊斯坦布尔大学切拉帕萨大学切拉帕萨医学院住院的 65 岁及以上 COVID-19 患者的回顾性研究。从电子病历中提取人口统计学、临床、治疗和实验室数据。我们使用单变量和多变量逻辑回归方法来探讨住院死亡的风险因素。
共纳入 218 例患者（男 112 例，女 106 例），其中 166 例出院，52 例住院死亡。单变量分析发现，各种临床特征和实验室变量存在显著差异（即 P<0.05）。多变量逻辑回归分析显示，以下因素与死亡率独立相关：存在恶性肿瘤[比值比（OR）=4.817，95%置信区间（CI）=1.107-20.958，P：0.036]；呼吸困难（OR=4.652，95%CI=1.473-14.688，P：0.009）；中性粒细胞/淋巴细胞比值（NLR；OR=1.097，95%CI=1.012-1.188，P：0.025）；C 反应蛋白（CRP；OR=1.006，95%CI=1.000-1.012，P：0.049）、乳酸脱氢酶（LDH；OR=1.002，95%CI=1.001-1.004，P：0.003）和肌酐水平（OR=1.497，95%CI=1.126-1.990，P：0.006）；入院时的血氧饱和度（SpO2）值（OR=0.897，95%CI=0.811-0.993，P：0.036）；以及使用阿奇霉素（OR=0.239，95%CI=0.065-0.874，P：0.031）。
存在恶性肿瘤；呼吸困难症状；高 NLR；最高 CRP、LDH 和肌酐水平；以及入院时低 SpO2 预测死亡率。另一方面，使用阿奇霉素被发现对死亡率有保护作用。了解预测死亡率的原因对于更成功地治疗未来病例将是重要的。
