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查尔森合并症指数在预测新冠病毒疾病患者不良临床结局及死亡率中的应用

Charlson Comorbidity Index in Predicting Poor Clinical Outcomes and Mortality in Patients with COVID-19.

作者信息

Argun Barış Serap, Boyacı Haşim, Akhan Sıla, Mutlu Birsen, Deniz Müge, Başyiğit İlknur

机构信息

Department of Pulmonary Diseases, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.

Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.

出版信息

Turk Thorac J. 2022 Mar;23(2):145-153. doi: 10.5152/TurkThoracJ.2022.21076.

Abstract

OBJECTIVE

As known, older age and comorbidities are associated with poor clinical outcomes in patients with coronavirus disease 19. The aim of this study was to investigate the effect of the Charlson Comorbidity Index in predicting poor clinical outcomes in coronavirus disease 19 patients.

MATERIAL AND METHODS

Demographic characteristics and poor clinical outcomes (presence of pneumonia, respiratory failure, intensive care unit admission, and mortality) of the patients were evaluated retrospectively. Classical and modified Charlson Comorbidity Index was calculated and adjusted according to age.

RESULTS

In this study, 106 women and 107 men were included. The comorbidity rate was 50.7% and the most common comorbidities were hypertension (21.6%) and diabetes mellitus (15%). The rates of respiratory failure, intensive care unit admission, and mortality were 15%, 2.3%, and 2.8%, respectively. Older age was a high risk for poor outcomes. Pneumonia (odds ratio: 6.6; 95% CI: 3.4-12.7), respiratory failure (odds ratio: 5.2; 95% CI: 2.03-13.2), and intensive care unit admission (odds ratio: 1.1; 95% CI: 1.01-1.1) were significantly higher in patients with comorbid diseases than patients without any comorbidity (P < .05). Both median-modified and classical Charlson Comorbidity Index and their age-adjusted scores were significantly higher in patients with poor outcomes.

CONCLUSIONS

It is suggested that evaluation of the Charlson Comorbidity Index might contribute to the management of the patients with coronavirus disease 19 by predicting risk group for poor clinical outcomes and mortality.

摘要

目的

众所周知,年龄较大和合并症与冠状病毒病19患者的临床预后不良相关。本研究的目的是调查查尔森合并症指数在预测冠状病毒病19患者临床预后不良方面的作用。

材料与方法

回顾性评估患者的人口统计学特征和不良临床结局(肺炎、呼吸衰竭、入住重症监护病房和死亡率)。计算经典和改良查尔森合并症指数,并根据年龄进行调整。

结果

本研究纳入了106名女性和107名男性。合并症发生率为50.7%,最常见的合并症是高血压(21.6%)和糖尿病(15%)。呼吸衰竭、入住重症监护病房和死亡率分别为15%、2.3%和2.8%。年龄较大是预后不良的高风险因素。合并症患者的肺炎(比值比:6.6;95%置信区间:3.4 - 12.7)、呼吸衰竭(比值比:5.2;95%置信区间:2.03 - 13.2)和入住重症监护病房(比值比:1.1;95%置信区间:1.01 - 1.1)显著高于无合并症患者(P < 0.05)。预后不良患者的中位改良和经典查尔森合并症指数及其年龄调整分数均显著更高。

结论

建议评估查尔森合并症指数可能有助于通过预测临床预后不良和死亡的风险组来管理冠状病毒病19患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a2/9449884/619c3109b1c3/ttj-23-2-145_f001.jpg

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