2019年冠状病毒病大流行期间成年患者在重症监护病房的临床表现模式、患病率及死亡相关因素:一项回顾性横断面研究

Patterns of presentation, prevalence and associated factors of mortality in ICU among adult patients during the pandemic of COVID 19: A retrospective cross-sectional study.

作者信息

Seid Shimelis, Adane Habtu, Mekete Getachew

机构信息

Department of Anesthesia, College of Health Sciences, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Anesthesia, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

Ann Med Surg (Lond). 2022 May;77:103618. doi: 10.1016/j.amsu.2022.103618. Epub 2022 Apr 14.

Abstract

BACKGROUND

There is concern that patients admitted to the intensive care unit (ICU) with Corona Virus Disease 2019 (COVID-19) have variable prevalence reports of mortality. The survival rates are also inconsistently reported due to varying follow-up periods. Even if data on outcomes and baseline characteristics of ICU patients with COVID-19 is essential for action planning to manage complications, it is still left undisclosed in our study setting.

MATERIALS AND METHOD

This cross-sectional study was conducted on 402 samples using a retrospective chart review of patient's data who were admitted in the past 2 years of the adult ICUs. All the data were entered and analyzed with SPSS version 21. A multivariable Logistic regression analysis was used to identify the association between outcome variables with independent factors and a p-value of less than 0.05 was taken as statistically significant with a 95% confidence interval. We used text, tables, and figures for the result.

RESULT

The overall prevalence of mortality among adult patients admitted to ICU during COVID-19 pandemics was 67.4%. From the multivariable logistic regression analysis, factors that were shown to have an association with an increase in ICU patient mortality were; lack of Vasopressor support, patients who had confirmed COVID 19 infection, core body temperature at admission greater than 37.5 °c, SPO2 at admission less than 90%, patients who had diagnosed ischemic heart disease (IHD), patients with acute respiratory distress syndrome (ARDS), patients who were intubated and mechanically ventilated (MV), and patient's ICU length of stay longer than two weeks.

CONCLUSION

The prevalence of ICU mortality in adult patients was higher in Debre Tabor Comprehensive specialized hospital. Therefore, clinicians need to minimize factors that maximize patient mortalities like ARDS, hyperthermia, Desaturation, Covid infection, IHD, intubation and MV, lack of Vasopressor use, and prolonged ICU stay.

摘要

背景

人们担心,因2019冠状病毒病(COVID - 19)入住重症监护病房(ICU)的患者死亡率报告存在差异。由于随访期不同,生存率报告也不一致。尽管关于COVID - 19的ICU患者的结局和基线特征数据对于管理并发症的行动计划至关重要,但在我们的研究环境中这些数据仍未公开。

材料与方法

本横断面研究对402个样本进行,采用回顾性图表审查过去两年入住成人ICU患者的数据。所有数据均使用SPSS 21版录入并分析。采用多变量逻辑回归分析确定结局变量与独立因素之间的关联,p值小于0.05被视为具有统计学意义,置信区间为95%。我们用文本、表格和图表展示结果。

结果

在COVID - 19大流行期间入住ICU的成年患者中,总体死亡率为67.4%。多变量逻辑回归分析显示,与ICU患者死亡率增加相关的因素包括:缺乏血管活性药物支持、确诊COVID - 19感染的患者、入院时核心体温高于37.5℃、入院时血氧饱和度低于90%、诊断为缺血性心脏病(IHD)的患者、患有急性呼吸窘迫综合征(ARDS)的患者、接受插管和机械通气(MV)的患者以及患者在ICU的住院时间超过两周。

结论

德布雷塔博尔综合专科医院成年患者的ICU死亡率较高。因此,临床医生需要尽量减少导致患者死亡率升高的因素,如ARDS、体温过高、血氧饱和度降低、新冠感染、IHD、插管和MV、缺乏血管活性药物使用以及ICU住院时间延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e31d/9142619/b94c205ca5b3/gr1.jpg

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