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[65岁以上因COVID-19住院患者的死亡风险因素]

[Risk factors for mortality in patients over 65 years old hospitalized by COVID-19].

作者信息

Fernández Ibáñez José Manuel, Morales Ballesteros María Del Carmen, Galindo Andúgar María Ángeles, Fernández Anguita Manuel José, Arias Arias Ángel, Barberá-Farré José Ramón

机构信息

Servicio de Medicina Interna, Sección Geriatría, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.

Servicio de Medicina Interna, Sección Geriatría, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.

出版信息

Rev Esp Geriatr Gerontol. 2022 Jan-Feb;57(1):6-12. doi: 10.1016/j.regg.2021.09.004. Epub 2021 Nov 12.

Abstract

BACKGROUND AND OBJECTIVE

COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has caused a global pandemic that we are currently suffering from.

OBJECTIVE

to identify factors associated with the death of patients aged 65 years or older hospitalized for COVID-19.

MATERIALS AND METHODS

Retrospective cohort study. We included patients aged 65 years or older who were hospitalized for COVID-19 and dead o discharged between March 5 and 25, 2020. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.

RESULTS

277 patients were included in this study. The bivariate analysis showed significant differences (p<0.05) between survivors and non survivors: age, increased dependence and comorbidity, history of ischemic heart disease, renal failure and non-hematological neoplasms, heart failure during admission, leukocytosis, elevated creatinine, PCR, GOT and troponin Ic values, lymphopenia, and decreased blood pH and SatO2. Multivariate logistic regression revealed that age ≥65 years (OR: 4.23 (95% CI: 1.43-12.52; p=0.009), lymphopenia <1000/μL (OR: 2.36 (95% CI: 1.07-5.20; p=0.033), creatinine>1.2mg/dL (OR: 3.08 (95% CI: 1.37-6.92; p=0.006), SatO <90% (OR: 2.29 (95% CI: 1.01-5.21; p=0.049) and troponin Ic>11ng/mL (OR: 2.32 (95% CI: 1.04-5.16; p=0.040) were independently associated with higher hospital mortality.

CONCLUSIONS

Older age, lymphopenia, SatO <90%, elevated creatinine and troponin Ic values were independently associated with higher mortality in hospitalized patients with COVID-19, these factors could help clinicians to identify patients with poor prognosis.

摘要

背景与目的

新型冠状病毒肺炎(COVID-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的疾病,已导致我们目前正在遭受的全球大流行。

目的

确定因COVID-19住院的65岁及以上患者死亡的相关因素。

材料与方法

回顾性队列研究。我们纳入了2020年3月5日至25日期间因COVID-19住院且死亡或出院的65岁及以上患者。我们使用单变量和多变量逻辑回归方法来探索与院内死亡相关的危险因素。

结果

本研究纳入了277例患者。双变量分析显示幸存者和非幸存者之间存在显著差异(p<0.05):年龄、依赖增加和合并症、缺血性心脏病史、肾衰竭和非血液系统肿瘤、入院时心力衰竭、白细胞增多、肌酐升高、PCR、谷草转氨酶(GOT)和肌钙蛋白Ic值、淋巴细胞减少以及血pH值和血氧饱和度(SatO2)降低。多变量逻辑回归显示,年龄≥65岁(比值比:4.23(95%置信区间:1.43 - 12.52;p = 0.009)、淋巴细胞减少<1000/μL(比值比:2.36(95%置信区间:1.07 - 5.20;p = 0.033)、肌酐>1.2mg/dL(比值比:3.08(95%置信区间:1.37 - 6.92;p = 0.006)、SatO2<90%(比值比:2.29(95%置信区间:1.01 - 5.21;p = 0.049)和肌钙蛋白Ic>11ng/mL(比值比:2.32(95%置信区间:1.04 - 5.16;p = 0.040)与较高的医院死亡率独立相关。

结论

年龄较大、淋巴细胞减少、SatO2<90%、肌酐升高和肌钙蛋白Ic值与COVID-19住院患者较高的死亡率独立相关,这些因素可帮助临床医生识别预后不良的患者。

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