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评估预测 COVID-19 老年患者(年龄大于 65 岁)需要重症监护的因素:来自土耳其一个急诊科的数据。

Evaluation of the factors predicting the need for intensive care of patients with COVID-19 aged above 65 years: data from an emergency department in Turkey.

机构信息

Canakkale Onsekiz Mart University, School of Medicine, Department of Emergency Medicine - Canakkale, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2021 Oct;67(10):1454-1460. doi: 10.1590/1806-9282.20210653.

DOI:10.1590/1806-9282.20210653
PMID:35018975
Abstract

OBJECTIVE

Individuals aged ≥65 years are more susceptible to COVID-19 disease and admission to intensive care is most notable. The scoring systems (national early warning score, quick sequential organ failure assessment, shock index) are recommended for rapid assessment of patients in emergency room conditions. The goal of our study is to evaluate scoring systems in conjunction with predictive factors of need for admission to intensive care of patients ≥65 years old with a diagnosis of COVID-19 who applied to the emergency room.

METHODS

Patients were divided into two groups according to evolution in the emergency room, being those who needed or not intensive care. National Early Warning Score, quick sequential organ failure assessment, shock index scores and serum biochemistry, blood count and blood gas values were evaluated from hospital information management system records.

RESULTS

Of the patients included in the study, 80.8% were admitted to the ward and 14.5% to the unit of intensive care. Lymphocyte count, base deficit and bicarbonate levels were lower, and the levels of C-reactive protein, lactate, D-dimer, urea and lactate dehydrogenase were higher in patients who needed intensive care. Quick sequential organ failure assessment and shock index were considered significant in the group admitted to the intensive care unit.

CONCLUSIONS

We recommend that quick sequential organ failure assessment and shock index be used quickly, practically and easily in predicting the need for intensive care unit in patients aged ≥65 years in emergency department diagnosed with COVID-19.

摘要

目的

年龄≥65 岁的个体更容易感染 COVID-19 疾病,并且需要入住重症监护病房的情况最为明显。评分系统(国家早期预警评分、快速序贯器官衰竭评估、休克指数)推荐用于在急诊室条件下快速评估患者。我们的研究目的是评估评分系统与预测因素的结合,以评估诊断为 COVID-19 并就诊于急诊室的≥65 岁老年患者需要入住重症监护病房的情况。

方法

根据在急诊室的演变情况将患者分为两组,即需要或不需要重症监护的患者。从医院信息管理系统记录中评估国家早期预警评分、快速序贯器官衰竭评估、休克指数评分以及血清生化、血常规和血气值。

结果

在纳入研究的患者中,80.8%被收治到病房,14.5%被收治到重症监护病房。需要重症监护的患者的淋巴细胞计数、碱缺失和碳酸氢盐水平较低,而 C 反应蛋白、乳酸、D-二聚体、尿素和乳酸脱氢酶水平较高。快速序贯器官衰竭评估和休克指数在被收治到重症监护病房的患者中被认为是显著的。

结论

我们建议在急诊室诊断为 COVID-19 的≥65 岁老年患者中,快速、实用且方便地使用快速序贯器官衰竭评估和休克指数来预测需要入住重症监护病房的情况。

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