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秘鲁卡哈马卡地区某医院与 COVID-19 病死率相关的因素。

Factors associated with COVID-19 lethality in a hospital in the Cajamarca region in Peru.

机构信息

Oficina de Epidemiología. Dirección Regional de Salud Cajamarca (DIRESA Cajamarca), Cajamarca, Perú.

Hospital Simón Bolívar, Cajamarca, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2021 Oct-Dec;38(4):501-511. doi: 10.17843/rpmesp.2021.384.8890. Epub 2022 Apr 1.

Abstract

OBJECTIVE.: To identify the clinical and epidemiological characteristics related to lethality in patients hospitalized for COVID-19 at the Simón Bolívar Hospital in Cajamarca, during June-August 2020.

MATERIALS AND METHODS.: This was a retrospective cohort, that used information collected from clinical records and official epidemiological surveillance systems (NOTIWEB, SISCOVID and SINADEF), on hospitalized patients with confirmed COVID-19 diagnosis. Information was collected on sociodemographic and clinical factors, considering discharge (death/survival) and days of hospitalization as outcomes.

RESULTS.: The in-hospital fatality rate was 39.6%, and significant differences were found between hospitalization time and status at discharge in people over 60 years of age (p<0.001). Age older than 60 years (HR: 2.87; 95% CI: 1.76-4.68),) unattended ICU bed request (HR: 3.49; 95% CI: 2.02-6.05), oxygen saturation less than 80% at admission (HR: 2.73; 95% CI: 1.35-5.53) and the use of ivermectin (HR: 1.68; 95%CI 1.06-2.68) were factors associated with lethality. The chosen ML model considered that the most important variables were oxygen saturation, age over 60 years, time of hospitalization and time of the onset of symptoms.

CONCLUSION.: The factors that could increase lethality in patients hospitalized for COVID-19 were age, oxygen saturation less than 80%, use of ivermectin as part of hospital treatment and unattended request for ICU beds. Future studies with better representativeness could confirm these possible relationships at the regional or national level.

摘要

目的

确定 2020 年 6 月至 8 月在卡哈马卡西蒙·玻利瓦尔医院因 COVID-19 住院的患者的临床和流行病学特征与死亡率相关。

材料和方法

这是一项回顾性队列研究,使用从临床记录和官方流行病学监测系统(NOTIWEB、SISCOVID 和 SINADEF)收集的信息,对确诊 COVID-19 诊断的住院患者进行分析。收集了社会人口统计学和临床因素的信息,将出院(死亡/存活)和住院天数作为结局。

结果

住院患者的病死率为 39.6%,60 岁以上患者的住院时间和出院状态存在显著差异(p<0.001)。年龄大于 60 岁(HR:2.87;95%CI:1.76-4.68)、未申请 ICU 病床(HR:3.49;95%CI:2.02-6.05)、入院时血氧饱和度<80%(HR:2.73;95%CI:1.35-5.53)和使用伊维菌素(HR:1.68;95%CI 1.06-2.68)是与死亡率相关的因素。选择的 ML 模型认为最重要的变量是血氧饱和度、年龄大于 60 岁、住院时间和症状发作时间。

结论

可增加 COVID-19 住院患者死亡率的因素是年龄、血氧饱和度<80%、伊维菌素作为医院治疗的一部分以及未申请 ICU 病床。未来在区域或国家层面进行的代表性更好的研究可以证实这些可能的关系。

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