Fistera David, Pabst Dirk, Falk Maximilian, Anastasiou Olympia E, Goer Stefan, Dolff Sebastian, Konik Margarethe, Herbstreit Frank, Taube Christian, Kill Clemens, Risse Joachim
Zentrum für Notfallmedizin, Universitätsmedizin Essen.
Universitätsmedizin Essen, Westdeutsches Lungenzentrum, Ruhrlandklinik.
Dtsch Med Wochenschr. 2022 Jan;147(3):e13-e22. doi: 10.1055/a-1522-1502. Epub 2021 Dec 29.
With more than 1400 COVID-19 inpatients, the university hospital of Essen is the main regional caregiver during COVID-19 pandemic. We present outcome data of our inpatients during the first 12 months of pandemic and our derived clinical care concepts.
Retrospective analysis of all 1396 COVID-19 inpatients presenting between March, 1 of 2020 and February, 28 of 2021 for comorbidities, survival and complications. Group comparison between patients receiving standard care and those requiring intermediate/ intensive care.
Mortality rate of all inpatients was 19,8 % (277/ 1396), whereas 10.6 % (93/877) of the patients with standard care and 35.5 % (184/519) of those with intermediate/intensive care died during hospital stay. Age above 60 years, obesity, need for mechanical ventilation, nitric oxide therapy, ECMO and acute renal failure as well as stroke during the clinical course were independent predictors of mortality.
The mortality of both patient groups ranges within the numbers published by other international groups. The vast impact of usual comorbidities could be observed as well as the high rate of complications in serious ill COVID-19 patients. The mean age of both patient groups was lower than expected (60 years standard care versus 63 years intermediate/ intensive care). A maximum of patient and staff protection measures, a fast and efficient testing strategy during primary triage, standardized concepts from emergency department to intensive care units and dynamic adjustment of resources to daily changing needs can ensure a high quality of care even during peak of pandemic.
埃森大学医院有超过1400名新冠肺炎住院患者，是新冠疫情期间该地区的主要医疗服务提供者。我们展示了疫情头12个月期间我们住院患者的治疗结果数据以及我们衍生出的临床护理理念。
对2020年3月1日至2021年2月28日期间收治的所有1396例新冠肺炎住院患者的合并症、生存率和并发症进行回顾性分析。对接受标准护理的患者和需要中级/重症护理的患者进行组间比较。
所有住院患者的死亡率为19.8%（277/1396），而接受标准护理的患者中有10.6%（93/877）在住院期间死亡，接受中级/重症护理的患者中有35.5%（184/519）在住院期间死亡。年龄在60岁以上、肥胖、需要机械通气、一氧化氮治疗、体外膜肺氧合（ECMO）、急性肾衰竭以及临床过程中的中风是死亡率的独立预测因素。
两组患者的死亡率在其他国际组织公布的范围内。可以观察到常见合并症的巨大影响以及重症新冠肺炎患者的高并发症发生率。两组患者的平均年龄均低于预期（标准护理组为60岁，中级/重症护理组为63岁）。最大限度的患者和医护人员保护措施、初级分诊期间快速有效的检测策略、从急诊科到重症监护病房的标准化理念以及根据每日变化的需求动态调整资源，即使在疫情高峰期也能确保高质量的护理。
