Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2021 Dec 3;19:eAO6739. doi: 10.31744/einstein_journal/2021AO6739. eCollection 2021.
To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality of patients with COVID-19 admitted to the intensive care unit.
Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) patients admitted to the intensive care unit, between March 4, 2020 and February 28, 2021 were included in this study. Patients were categorized between survivors and non-survivors according to hospital discharge.
During the study period, 1,296 patients [median (interquartile range) age: 66 (53-77) years] with COVID-19 were admitted to the intensive care unit. Out of those, 170 (13.6%) died at hospital (non-survivors) and 1,078 (86.4%) were discharged (survivors). Compared to survivors, non-survivors were older [80 (70-88) versus 63 (50-74) years; p<0.001], had a higher Simplified Acute Physiology Score 3 [59 (54-66) versus 47 (42-53) points; p<0.001], and presented comorbidities more frequently. During the intensive care unit stay, 56.6% of patients received noninvasive ventilation, 32.9% received mechanical ventilation, 31.3% used high flow nasal cannula, 11.7% received renal replacement therapy, and 1.5% used extracorporeal membrane oxygenation. Independent predictors of in-hospital mortality included age, Sequential Organ Failure Assessment score, Charlson Comorbidity Index, need for mechanical ventilation, high flow nasal cannula, renal replacement therapy, and extracorporeal membrane oxygenation support.
Patients with severe COVID-19 admitted to the intensive care unit exhibited a considerable morbidity and mortality, demanding substantial organ support, and prolonged intensive care unit and hospital stay.
描述 COVID-19 患者入住重症监护病房的临床特征、资源利用情况、结局，并确定院内死亡率的预测因素。
这是一项在巴西圣保罗（SP）的一家私立医院进行的回顾性单中心队列研究。本研究纳入了 2020 年 3 月 4 日至 2021 年 2 月 28 日期间连续入住重症监护病房的所有成年（≥18 岁）COVID-19 患者。根据出院情况，将患者分为存活组和非存活组。
研究期间，共有 1296 例 COVID-19 患者（中位数[四分位间距]年龄：66 [53-77] 岁）入住重症监护病房。其中，170 例（13.6%）死亡（非存活者），1078 例（86.4%）出院（存活者）。与存活者相比，非存活者年龄更大[80 [70-88] 岁比 63 [50-74] 岁；p<0.001]，Simplified Acute Physiology Score 3 评分更高[59 [54-66] 分比 47 [42-53] 分；p<0.001]，且合并症更为常见。在重症监护病房期间，56.6%的患者接受无创通气，32.9%的患者接受机械通气，31.3%的患者使用高流量鼻导管，11.7%的患者接受肾脏替代治疗，1.5%的患者接受体外膜氧合。院内死亡率的独立预测因素包括年龄、序贯器官衰竭评估评分、Charlson 合并症指数、需要机械通气、高流量鼻导管、肾脏替代治疗和体外膜氧合支持。
入住重症监护病房的严重 COVID-19 患者发病率和死亡率较高，需要大量器官支持，并延长重症监护病房和住院时间。
