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住院COVID-19患者的死亡率预测因素:一项基于墨西哥人群的队列研究。

Predictors of mortality in hospitalized COVID-19 patients: A Mexican population-based cohort study.

作者信息

Mesta Fernando, Coll Angel M, Ramírez Miguel Á, Delgado-Roche Livan

机构信息

Department of Occupational Health, Safety and Hygiene Research, National Medicine and Homeopathy School of the National Polytechnic Institute, 239 Guillermo Massieu Helguera Ave, La Escalera, 07320, Mexico City, Mexico.

AbbVie Farmacéuticos, S.A. de C.V. 3720 Building 3, Office 10-001, Jardines Del Pedregal, 01900, Mexico City, Mexico.

出版信息

Biomedicine (Taipei). 2021 Jun 1;11(2):1-4. doi: 10.37796/2211-8039.1124. eCollection 2021.

Abstract

OBJECTIVES

COVID-19 outbreak brings a challenge to healthcare systems. The sex, age, and cardiometabolic comorbidities have been considered risk factors for disease severity. To evaluate the association between risk factors with death as well the risk of death in hospitalized COVID-19 patients.

METHODS

The present cross-sectional cohort study, includes hospitalized SARS-CoV-2 confirmed cases. Data analysis was performed using the National COVID-19 Cases Report Database. Pearson's χ test and odds ratios (95% CI) were calculated to determine the association between variables. Thereafter, risk of death was evaluated by Cox proportional hazards model.

RESULTS

A total of 67 328 inpatients were included; mean age 55.29 years (±15.97). Of total, 42 164 (62.62%) were men, 6 349 (9.43%) were intubated, and 23 873 (35.46%) died. Male sex, age older than 60 years, and cardiometabolic comorbidities were associated with death. Hazard ratio for death in older intubated patients was lower than in non-intubated (HR 1.242, 95%CI, 1.167-1.322; < 0.001) and (HR 2.128, 95%CI, 2.066-2.193; < 0.001) respectively.

CONCLUSIONS

Tracheal intubation or not is the most important predictor for death in COVID-19 infected patients in this Mexican cohort. Already known risk factors for COVID-19 severity may become less relevant once patients require tracheal intubation.

摘要

目的

新型冠状病毒肺炎(COVID-19)疫情给医疗系统带来了挑战。性别、年龄和心血管代谢合并症被认为是疾病严重程度的风险因素。本研究旨在评估住院COVID-19患者的风险因素与死亡之间的关联以及死亡风险。

方法

本横断面队列研究纳入了住院的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)确诊病例。使用国家COVID-19病例报告数据库进行数据分析。计算Pearson卡方检验和比值比(95%置信区间)以确定变量之间的关联。此后,通过Cox比例风险模型评估死亡风险。

结果

共纳入67328名住院患者;平均年龄55.29岁(±15.97)。其中,男性42164名(62.62%),6349名(9.43%)接受了气管插管,23873名(35.46%)死亡。男性、60岁以上年龄以及心血管代谢合并症与死亡相关。插管老年患者的死亡风险比未插管患者低(风险比分别为1.242,95%置信区间为1.167-1.322;P<0.001)和(风险比为2.128,95%置信区间为2.066-2.193;P<0.001)。

结论

在这个墨西哥队列中,气管插管与否是COVID-19感染患者死亡的最重要预测因素。一旦患者需要气管插管,已知的COVID-19严重程度风险因素可能变得不那么重要。

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