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根据疾病严重程度分析意大利新冠肺炎住院患者的死亡率及输血需求

Mortality and Transfusion Requirements in COVID-19 Hospitalized Italian Patients According to Severity of the Disease.

作者信息

Grandone Elvira, Pesavento Raffaele, Tiscia Giovanni, De Laurenzo Antonio, Ceccato Davide, Sartori Maria Teresa, Mirabella Lucia, Cinnella Gilda, Mastroianno Mario, Dalfino Lidia, Colaizzo Donatella, Vettor Roberto, Ostuni Angelo, Margaglione Maurizio

机构信息

Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.

Ob/Gyn Department of the First I.M. Sechenov Moscow State Medical University, 119435 Moscow, Russia.

出版信息

J Clin Med. 2021 Jan 11;10(2):242. doi: 10.3390/jcm10020242.

Abstract

There is paucity of data on the transfusion need and its impact on the overall mortality in patients with COVID-19. We explored mortality in hospitalized patients with COVID-19 who required transfusions. Information on clinical variables and in-hospital mortality were obtained from medical records of 422 patients admitted to medical wards or the Intensive Care Unit (ICU). In-hospital mortality occurred in 147 (34.8%) patients, 94 (63.9%) of whom were admitted to the ICU. The median fatalities age was 77 years (IQR 14). Overall, 100 patients (60 males) received transfusion during hospitalization. The overall mortality was significantly and independently associated with age, ICU admission, Chronic Kidney Disease (CKD), and the number of transfused Red Blood Cell (RBC) units. Specifically, CKD was associated with mortality in patients admitted to medical wards, whereas the number of transfused RBC units predicted mortality in those admitted to the ICU. Transfusion strongly interacted with the admission to ICU (OR: 9.9; 95% CI: 2.5-40.0). In patients with COVID-19, age is one of the strongest risk factors in predicting mortality independently of the disease's severity. CKD confers a higher risk of mortality in patients admitted to medical wards. In those admitted to the ICU, the more RBC units are transfused, the more mortality increases.

摘要

关于新型冠状病毒肺炎(COVID-19)患者的输血需求及其对总体死亡率的影响,目前数据匮乏。我们探讨了需要输血的COVID-19住院患者的死亡率。从422名入住内科病房或重症监护病房(ICU)患者的病历中获取临床变量和院内死亡率信息。147名(34.8%)患者发生院内死亡,其中94名(63.9%)入住ICU。死亡患者的中位年龄为77岁(四分位间距14)。总体而言,100名患者(60名男性)在住院期间接受了输血。总体死亡率与年龄、入住ICU、慢性肾脏病(CKD)以及输注红细胞(RBC)单位数量显著且独立相关。具体而言,CKD与内科病房入院患者的死亡率相关,而输注RBC单位数量可预测ICU入院患者的死亡率。输血与入住ICU存在强烈的交互作用(比值比:9.9;95%置信区间:2.5 - 40.0)。在COVID-19患者中,年龄是独立于疾病严重程度预测死亡率的最强危险因素之一。CKD使内科病房入院患者的死亡风险更高。在入住ICU的患者中,输注的RBC单位越多,死亡率增加得越多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aa4/7826536/b9c804b0a22b/jcm-10-00242-g001.jpg

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