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动脉血氧饱和度和其他临床预测因子与 COVID-19 患者的生存:尼日利亚一家三级保健医院病例回顾。

Arterial Oxygen Saturation and other Clinical Predictors of Survival in Patients with Covid-19: A Review of Cases in a Tertiary Care Hospital in Nigeria.

机构信息

Department of Medicine, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State,Nigeria.

Department of Community Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State,Nigeria.

出版信息

West Afr J Med. 2021 Feb;38(2):109-113.

Abstract

BACKGROUND

We assessed clinical parameters in patients confirmed to have COVID-19 in relation to arterial hypoxaemia and survival.

METHODOLOGY

This was a retrospective chart review of patients who were confirmed positive for SARS-CoV-2 virus by Real Time-Polymerase Chain Reaction (RT-PCR) testing. Data extracted from patients' case files included patient demographics, presenting symptoms, provisional diagnoses, and outcomes of hospitalisation. Descriptive variables were summarized; proportions were compared using Chi-square tests, and independent predictors of mortality were assessed using multivariate regression analysis. A p-value of < 0.05 was considered as statistically significant.

RESULTS

There were a total of 61 patients with positive RT-PCR testing: mean age ± SD (minimum - maximum) was 53.0 ± 18.5 (5 months - 90) years. Persons aged 60 years and above were the largest group (n=24, 39.3%). More than half were male (n=35, 57.4%); about 43% had one morbidity; 41.0% had at least two co-morbidities. The mean (SD) arterial oxygen saturation (SpO2) was 86.9% ± 16.7. Patients who were clinically dyspnoeic at presentation, and who had co-morbidities were significantly more hypoxaemic (p = 0.026 and 0.04, respectively). Significantly more patients who had normal oxygen saturation at presentation survived (p = 0.006). None of these variables was an independent predictor of mortality, however.

CONCLUSION

Arterial hypoxaemia was significantly associated with dyspnoea and underlying disease, and normal oxygen saturation at presentation was significantly associated with survival. Hospital managers and clinicians may thus prioritize routine pulse oximetry, supplemental oxygen therapy and management of co-morbidities in the COVID-19 fight.

摘要

背景

我们评估了已确诊患有 COVID-19 的患者的临床参数与动脉低氧血症和生存率的关系。

方法

这是一项回顾性图表审查,对通过实时聚合酶链反应(RT-PCR)检测确诊为 SARS-CoV-2 病毒阳性的患者进行了研究。从患者病历中提取的数据包括患者的人口统计学特征、临床表现、暂定诊断和住院结局。总结描述性变量;使用卡方检验比较比例,使用多变量回归分析评估死亡率的独立预测因素。p 值<0.05 被认为具有统计学意义。

结果

共有 61 例 RT-PCR 检测阳性患者:平均年龄±标准差(最小-最大)为 53.0±18.5(5 个月-90 岁)。60 岁及以上的患者人数最多(n=24,39.3%)。超过一半为男性(n=35,57.4%);约 43%有一个合并症;41.0%至少有两个合并症。平均(SD)动脉血氧饱和度(SpO2)为 86.9%±16.7。就诊时出现临床呼吸困难和患有合并症的患者显著低氧血症发生率更高(p=0.026 和 0.04,分别)。就诊时血氧饱和度正常的患者显著更易存活(p=0.006)。然而,这些变量均不是死亡率的独立预测因素。

结论

动脉低氧血症与呼吸困难和基础疾病显著相关,就诊时血氧饱和度正常与生存率显著相关。因此,医院管理者和临床医生可能会在 COVID-19 防控中优先考虑常规脉搏血氧仪、补充氧气治疗和合并症管理。

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