Centro Andaluz de Información de Medicamentos (Cadime), Escuela Andaluza de Salud Pública, Granada. Spain. Instituto de Investigación Biosanitaria ibs, Granada. Spain. IBER en Epidemiología y Salud Pública (CIBERESP). Spain..
Pharmacy Department, Hospital Universitario Ramón y Cajal, Madrid. Spain..
Farm Hosp. 2022 Jan 8;46(2):57-71.
To determine the baseline characteristics associated with higher mortality at 42 days in patients hospitalized for COVID-19 in Spain.
The study analyzed a prospective cohort of hospitalized COVID-19 patients. The dependent variable was 42-day mortality. Data on the subjects' demographic and clinical characteristics, comorbidities, usual therapy and supportive interventions and treatments was collected within 48 hours from admission. To determine the potential association of the data with mortality, a multivariate analysis was performed using logistic regression.
15,628 patients were included, 18.2% of whom (n = 2,806) died during the study period. According to the multivariate analysis, the variables that were significantly associated (p < 0.05) with mortality upon admission were: being referred from a nursing home (OR 1.9); having a high respiratory rate (OR 1,5); having moderate (OR 1.7) or severe (OR 2.9) pneumonia (CURB-65); aspartate aminotransferase transaminase ≥ 100 IU/l (OR 2.1); lactate dehydrogenase ≥ 360 IU/L (OR 1.6); procalcitonin > 0.5 ng/mL (OR 1.8); creatine kinase ≥ 294 U/L (OR 1.5); D-dimer > 3,000 ng/mL (OR 1.5); hemoglobin < 11.6 g/dL (OR 1.4) and C-reactive protein > 120 mg/L (OR 1.2; requiring respiratory support within the first 48 hours (oxygen therapy [OR 2.0], non-invasive ventilation [OR 2.8], and mechanical ventilation [OR 3.5]); and being treated with interferon-beta (OR 1.5). On the contrary, being under 80 years of age was associated with lower mortality.
The analysis, based on the data in the RERFAR registry, showed that the factors associated with poorer prognosis were older age, assessed using the CURB-65 scale, level of respiratory support required, severe pneumonia (CURB-65), hypertransaminasemia, elevated creatine kinase, lactate dehydrogenase, and D-dimer levels, anemia, and elevated respiratory rate.
确定与西班牙因 COVID-19 住院患者 42 天死亡率较高相关的基线特征。
本研究分析了一项前瞻性 COVID-19 住院患者队列研究。因变量为 42 天死亡率。在入院后 48 小时内收集了受试者的人口统计学和临床特征、合并症、常规治疗和支持性干预和治疗的数据。为了确定数据与死亡率的潜在关联，使用逻辑回归进行了多变量分析。
共纳入 15628 例患者，其中 18.2%（n=2806）在研究期间死亡。根据多变量分析，入院时与死亡率显著相关（p<0.05）的变量为：从疗养院转来（OR 1.9）；呼吸急促（OR 1.5）；中度（OR 1.7）或重度（OR 2.9）肺炎（CURB-65）；天冬氨酸转氨酶转氨酶≥100IU/L（OR 2.1）；乳酸脱氢酶≥360IU/L（OR 1.6）；降钙素原>0.5ng/ml（OR 1.8）；肌酸激酶≥294U/L（OR 1.5）；D-二聚体>3000ng/ml（OR 1.5）；血红蛋白<11.6g/dL（OR 1.4）和 C 反应蛋白>120mg/L（OR 1.2）；在前 48 小时内需要呼吸支持（氧疗[OR 2.0]、无创通气[OR 2.8]和机械通气[OR 3.5]）；以及接受干扰素-β治疗（OR 1.5）。相反，年龄在 80 岁以下与死亡率较低相关。
基于 RERFAR 登记处的数据进行的分析表明，与预后较差相关的因素包括使用 CURB-65 量表评估的年龄较大、所需呼吸支持水平、严重肺炎（CURB-65）、高转氨酶血症、肌酸激酶升高、乳酸脱氢酶升高、D-二聚体水平升高、贫血和呼吸急促。
