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埃塞俄比亚一家三级护理医院中住院的新冠肺炎患者的死亡预测因素

Predictors of Mortality Among Hospitalized COVID-19 Patients at a Tertiary Care Hospital in Ethiopia.

作者信息

Ayana Galana Mamo, Merga Bedasa Taye, Birhanu Abdi, Alemu Addisu, Negash Belay, Dessie Yadeta

机构信息

School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.

School of Medicine, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.

出版信息

Infect Drug Resist. 2021 Dec 14;14:5363-5373. doi: 10.2147/IDR.S337699. eCollection 2021.

Abstract

BACKGROUND

The very unprecedented virus causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued causing catastrophes in economy and loss of human lives. Despite countries' urgent and resilient public health actions against the COVID-19 pandemic, the disease is causing a large number of deaths. However, predictors of mortality among hospitalized COVID-19 patients have not been well investigated in Ethiopia. Therefore, this study aimed to identify the predictors of mortality among hospitalized COVID-19 patients at a tertiary care hospital in Ethiopia.

METHODS

A hospital-based retrospective cohort design study was implemented among hospitalized COVID-19 patients at a tertiary care hospital in Harar, Ethiopia from March 20 to August 20, 2021. Data of 531 admitted patients were entered using Epi-data 3.1 and exported to STATA 14.2 for analysis. Binary logistic regression was used to identify significant predictors of outcome variables with an adjusted odds ratio (AOR) with a 95% confidence interval.

RESULTS

Of the total 531 study participants, 101 deaths occurred. The mortality rate was 16.2 per 1000 person-days of observation with median survival time of 44 days with IQR [28, 74]. Smoking history [AOR=2.55, 95% CI (1.15, 5.65)], alcohol history [AOR=2.3, 95% CI (1.06, 4.97)], comorbidities [AOR=2.95, 95% CI (1.26, 6.91)], and increasing oxygen saturation [AOR=0.92, 95% CI (0.89, 0.95)], and lymphocyte count [AOR=0.90, 95% CI (0.88, 0.97)] were independent significant predictors of death from Covid-19.

CONCLUSION

The incidence of mortality among hospitalized COVID-19 patients was found to be high. Devising individual, tailored management for patients with "risk" behaviors, comorbid conditions, and poor prognostic markers such as lymphopenia and low oxygen saturation, may reduce the incidence of death among hospitalized COVID-19 patients.

摘要

背景

导致严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的这种史无前例的病毒持续给经济带来灾难并造成人员生命损失。尽管各国针对新冠疫情采取了紧急且有效的公共卫生行动,但该疾病仍导致大量死亡。然而,在埃塞俄比亚,住院的新冠患者的死亡预测因素尚未得到充分研究。因此,本研究旨在确定埃塞俄比亚一家三级护理医院中住院的新冠患者的死亡预测因素。

方法

2021年3月20日至8月20日,在埃塞俄比亚哈勒尔的一家三级护理医院对住院的新冠患者开展了一项基于医院的回顾性队列设计研究。使用Epi-data 3.1录入531例入院患者的数据,并导出到STATA 14.2进行分析。采用二元逻辑回归来确定结局变量的显著预测因素,并计算调整后的优势比(AOR)及95%置信区间。

结果

在531名研究参与者中,共发生101例死亡。死亡率为每1000人日观察期16.2例,中位生存时间为44天,四分位间距为[28, 74]。吸烟史[AOR=2.55,95%置信区间(1.15, 5.65)]、饮酒史[AOR=2.3,95%置信区间(1.06, 4.97)]、合并症[AOR=2.95,95%置信区间(1.26, 6.91)]、氧饱和度升高[AOR=0.92,95%置信区间(0.89, 0.95)]以及淋巴细胞计数[AOR=0.90,95%置信区间(0.88, 0.97)]是新冠死亡的独立显著预测因素。

结论

发现住院的新冠患者死亡率较高。为有“风险”行为、合并症以及淋巴细胞减少和低氧饱和度等不良预后指标的患者制定个性化、针对性的管理措施,可能会降低住院新冠患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7813/8685765/a2fb5a15557f/IDR-14-5363-g0001.jpg

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