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新型冠状病毒肺炎相关急性呼吸衰竭需要机械通气患者的死亡率及预测因素:一项回顾性单中心研究

Mortality Rate and Predictors Among Patients with COVID-19 Related Acute Respiratory Failure Requiring Mechanical Ventilation: a Retrospective Single Centre Study.

作者信息

de Terwangne Christophe, Sorgente Antonio, Tortora Redente, Cheung Diana, Duprez Frederic, Place Sammy, Lechien Jerome R, Capulzini Lucio, Cubber Michael De, Saussez Sven, Taccone Fabio Silvio, Mashayekhi Shahram

机构信息

Department of Internal Medicine, Centre Hospitalier EpiCURA Hornu, Hornu, Belgium.

Department of Cardiology, Centre Hospitalier EpiCURA, Hornu, Belgium.

出版信息

J Crit Care Med (Targu Mures). 2021 Jan 29;7(1):21-27. doi: 10.2478/jccm-2020-0043. eCollection 2021 Jan.

Abstract

AIM

The objective of the study was to assess mortality rates in COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) who also requiring mechanical ventilation. The predictors of mortality in this cohort were analysed, and the clinical characteristics recorded.

MATERIAL AND METHOD

A single centre retrospective study was conducted on all COVID-19 patients admitted to the intensive care unit of the Epicura Hospital Center, Province of Hainaut, Belgium, between March 1st and April 30th 2020.

RESULTS

Forty-nine patients were included in the study of which thirty-four were male, and fifteen were female. The mean (SD) age was 68.8 (10.6) and 69.5 (12.6) for males and females, respectively. The median time to death after the onset of symptoms was eighteen days. The median time to death, after hospital admission was nine days. By the end of the thirty days follow-up, twenty-seven patients (55%) had died, and twenty-two (45%) had survived. Non-survivors, as compared to those who survived, were similar in gender, prescribed medications, COVID-19 symptoms, with similar laboratory test results. They were significantly older (p = 0.007), with a higher co-morbidity burden (p = 0.026) and underwent significantly less tra-cheostomy (p < 0.001). In multivariable logistic regression analysis, no parameter significantly predicted mortality.

CONCLUSIONS

This study reported a mortality rate of 55% in critically ill COVID-19 patients with ARDS who also required mechanical ventilation. The results corroborate previous findings that older and more comorbid patients represent the population at most risk of a poor outcome in this setting.

摘要

目的

本研究的目的是评估患有急性呼吸窘迫综合征(ARDS)且需要机械通气的新冠肺炎患者的死亡率。分析该队列中死亡率的预测因素,并记录临床特征。

材料与方法

对2020年3月1日至4月30日期间入住比利时埃皮库拉医院中心重症监护病房的所有新冠肺炎患者进行了一项单中心回顾性研究。

结果

49名患者纳入研究,其中34名男性,15名女性。男性和女性的平均(标准差)年龄分别为68.8(10.6)岁和69.5(12.6)岁。症状出现后至死亡的中位时间为18天。入院后至死亡的中位时间为9天。在30天随访结束时,27名患者(55%)死亡,22名患者(45%)存活。与幸存者相比,非幸存者在性别、所开药物、新冠肺炎症状以及实验室检查结果方面相似。他们年龄显著更大(p = 0.007),合并症负担更高(p = 0.026),且气管切开术显著更少(p < 0.001)。在多变量逻辑回归分析中,没有参数能显著预测死亡率。

结论

本研究报告了患有ARDS且需要机械通气的重症新冠肺炎患者的死亡率为55%。结果证实了先前的研究结果,即在这种情况下,年龄较大且合并症较多的患者是预后不良风险最高的人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0528/8519373/c5727faaae6e/jccm-07-021-g001.jpg

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