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日本大阪新冠肺炎重症监护病房患者的特征与生存情况:一项回顾性观察研究

Characteristics and Survival of Intensive Care Unit Patients with Coronavirus Disease in Osaka, Japan: A Retrospective Observational Study.

作者信息

Zha Ling, Sobue Tomotaka, Takeuchi Taro, Tanaka Kenta, Katayama Yusuke, Komukai Sho, Hirayama Atsushi, Shimazu Takeshi, Kitamura Tetsuhisa

机构信息

Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan.

Traumatology and Acute Critical Medicine, Department of Acute Critical Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita 565-0871, Japan.

出版信息

J Clin Med. 2021 Jun 3;10(11):2477. doi: 10.3390/jcm10112477.

Abstract

The epidemiological and clinical characteristics, treatments, and outcomes of patients with coronavirus disease 2019 (COVID-19) who are admitted to the intensive care unit (ICU) have not been adequately evaluated in Japan. We analyzed the registry data of 205 patients with COVID-19 admitted to the ICU between February and November 2020, in Osaka Prefecture, Japan. A Cox proportional hazards model was used to assess the association between epidemiological factors and mortality among ICU patients. Of the 205 ICU patients, 161 (78.5%) were men and 149 (72.7%) were older than 60 years. A total of 117 patients (57.1%) had comorbidities. The most common symptoms at diagnosis were mild ( = 131, 63.9%). A total of 187 patients (91.2%) received mechanical ventilation, and 32 patients (15.6%) required extracorporeal membrane oxygenation. Patients were followed up for a median of 25 days after ICU admission. A total of 147 patients (71.7%) were alive at discharge, and 58 patients (28.3%) died. The hazard ratio for mortality among patients aged >80 years was 6.02 (95% confidence interval: 2.10-17.25) in the multivariable model, which was higher than that among those aged ≤59 years. These results are useful for recognizing the clinical course of this infection in ICU patients.

摘要

2019年冠状病毒病(COVID-19)患者入住重症监护病房(ICU)后的流行病学和临床特征、治疗方法及预后情况,在日本尚未得到充分评估。我们分析了2020年2月至11月期间,日本大阪府205例入住ICU的COVID-19患者的登记数据。采用Cox比例风险模型评估ICU患者的流行病学因素与死亡率之间的关联。205例ICU患者中,161例(78.5%)为男性,149例(72.7%)年龄大于60岁。共有117例患者(57.1%)存在合并症。诊断时最常见的症状为轻症(n = 131,63.9%)。共有187例患者(91.2%)接受了机械通气,32例患者(15.6%)需要体外膜肺氧合。患者在入住ICU后中位随访25天。共有147例患者(71.7%)出院时存活,58例患者(28.3%)死亡。在多变量模型中,年龄>80岁患者的死亡风险比为6.02(95%置信区间:2.10 - 17.25),高于年龄≤59岁的患者。这些结果有助于认识ICU患者中这种感染的临床病程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/800e/8199743/14b07d22d78b/jcm-10-02477-g001.jpg

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