U.O.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy.
Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
Sci Rep. 2021 Jan 13;11(1):1137. doi: 10.1038/s41598-020-80679-2.
An accurate prediction of the clinical outcomes of European patients requiring hospitalisation for Coronavirus Disease 2019 (COVID-19) is lacking. The aim of the study is to identify predictors of in-hospital mortality and discharge in a cohort of Lombardy patients with COVID-19. All consecutive hospitalised patients from February 21st to March 30th, 2020, with confirmed COVID-19 from the IRCCS Policlinico San Matteo, Pavia, Lombardy, Italy, were included. In-hospital mortality and discharge were evaluated by competing risk analysis. The Fine and Gray model was fitted in order to estimate the effect of covariates on the cumulative incidence functions (CIFs) for in-hospital mortality and discharge. 426 adult patients [median age 68 (IQR 56 to 77 years)] were admitted with confirmed COVID-19 over a 5-week period; 292 (69%) were male. By 21 April 2020, 141 (33%) of these patients had died, 239 (56%) patients had been discharged and 46 (11%) were still hospitalised. Among these 46 patients, updated as of 30 May, 2020, 5 (10.9%) had died, 8 (17.4%) were still in ICU, 12 (26.1%) were transferred to lower intensity care units and 21 (45.7%) were discharged. Regression on the CIFs for in-hospital mortality showed that older age, male sex, number of comorbidities and hospital admission after March 4th were independent risk factors associated with in-hospital mortality. Older age, male sex and number of comorbidities definitively predicted in-hospital mortality in hospitalised patients with COVID-19.
对于需要住院治疗的 2019 年冠状病毒病（COVID-19）的欧洲患者的临床结局进行准确预测尚缺乏相关研究。本研究旨在确定意大利伦巴第地区 COVID-19 住院患者的住院死亡率和出院率的预测因素。该研究纳入了 2020 年 2 月 21 日至 3 月 30 日期间从意大利帕维亚圣马特奥综合医院确诊为 COVID-19 的连续住院患者。通过竞争风险分析评估住院死亡率和出院率。使用 Fine 和 Gray 模型来估计协变量对住院死亡率和出院率的累积发生率函数（CIF）的影响。在 5 周的时间内，共有 426 名成年患者（中位年龄 68 岁（IQR 56 至 77 岁））被确诊为 COVID-19 并住院治疗；292 名（69%）为男性。截至 2020 年 4 月 21 日，其中 141 名（33%）患者死亡，239 名（56%）患者出院，46 名（11%）仍在住院治疗。在这 46 名患者中，截至 2020 年 5 月 30 日更新数据显示，5 名（10.9%）患者死亡，8 名（17.4%）仍在 ICU，12 名（26.1%）转至低强度护理病房，21 名（45.7%）出院。CIF 分析表明，年龄较大、男性、合并症数量以及 3 月 4 日后住院是与住院死亡率相关的独立危险因素。年龄较大、男性和合并症数量是 COVID-19 住院患者住院死亡率的明确预测因素。
