在埃塞俄比亚东部住院的 COVID-19 成年患者中器官衰竭的发生率和预测因素。基于医院的回顾性队列研究。
Incidence and predictors of organ failure among COVID-19 hospitalized adult patients in Eastern Ethiopia. Hospital-based retrospective cohort study.
机构信息
School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
出版信息
BMC Infect Dis. 2022 Apr 28;22(1):412. doi: 10.1186/s12879-022-07402-6.
BACKGROUND
Organ failure is incapability of at least one of the body organs to carry out a normal body functions. Identifying the predictors of the organ failure is crucial for improving COVID-19 patients' survival. However, the evidence related to this information is not well-established in developing countries, including Ethiopia. Therefore, this study aimed to determine the incidence and predictors of organ failure among adult patients admitted to Hiwot Fana Specialized University Hospital (HFSUH) COVID-19 treatment center from 1st May 2020 to 20th August 2021, Eastern Ethiopia.
METHODS
A hospital-based retrospective cohort study design was implemented. Descriptive measures such as mean with standard deviation (SD), median with interquartile range (IQR), percentages, and frequencies were computed. The binary logistic regression was used to identify the association between outcome variables (organ functional status) and independent variables with an adjusted odds ratio (AOR) at a 95% confidence interval. A significance level was declared at a p-value of less than 0.05.
RESULTS
The mean age of study participants was 47.69 years with the standard deviation (SD) of ± 17.03. The study participants were followed for the median time of 8 days with IQR of 4, 14. The incidence of organ failure was 11.9 per 1000 person-day contribution (95% CI: 9.5, 14.9). Predictors such as age above 60 years (AOR = 1.71, 95% CI: 1.44, 4.53), smoking history (AOR = 5.07, 95% CI: 1.39, 8.15), cardiovascular disease (AOR = 5.00, 95% CI: (1.83, 11.72), and critical clinical stages of COVID-19 (AOR = 5.42, 95%: 1.47, 14. 84) were significantly associated with organ failure among COVID-19 hospitalized patients.
CONCLUSIONS
The incidence of organ failure was 11.9 per 1000 person-day contribution. Age, smoking, comorbidity, and clinical stages were significantly associated with organ failure among COVID-19 hospitalized cases. Therefore, clinicians should stringently follow the patients experiencing modifiable predictors of organ failure, especially patients with comorbidities and severe clinical stages. Moreover, the prevention programs that target elders and smokers should be strengthening to save this segment of populations before suffering from organ failure following COVID-19.
背景
器官衰竭是指身体至少一个器官无法正常执行身体功能。识别器官衰竭的预测因素对于提高 COVID-19 患者的生存率至关重要。然而，在包括埃塞俄比亚在内的发展中国家，关于这方面的证据并不完善。因此，本研究旨在确定 2020 年 5 月 1 日至 2021 年 8 月 20 日期间在埃塞俄比亚东部的 Hiwot Fana 专门大学医院（HFSUH）COVID-19 治疗中心住院的成年患者发生器官衰竭的发生率和预测因素。
方法
采用基于医院的回顾性队列研究设计。计算了均值（标准差）、中位数（四分位距）、百分比和频率等描述性指标。使用二元逻辑回归来确定结局变量（器官功能状态）与独立变量之间的关联，并以 95%置信区间的调整比值比（AOR）表示。以 p 值<0.05 为显著性水平。
结果
研究参与者的平均年龄为 47.69 岁，标准差（SD）为±17.03。研究参与者的中位随访时间为 8 天，四分位距为 4、14。器官衰竭的发生率为每 1000 人日贡献 11.9 例（95%CI：9.5，14.9）。年龄在 60 岁以上（AOR=1.71，95%CI：1.44，4.53）、吸烟史（AOR=5.07，95%CI：1.39，8.15）、心血管疾病（AOR=5.00，95%CI：1.83，11.72）和 COVID-19 的危急临床阶段（AOR=5.42，95%CI：1.47，14.84）等预测因素与 COVID-19 住院患者的器官衰竭显著相关。
结论
器官衰竭的发生率为每 1000 人日贡献 11.9 例。年龄、吸烟、合并症和临床阶段与 COVID-19 住院患者的器官衰竭显著相关。因此，临床医生应严格监测出现器官衰竭可改变预测因素的患者，尤其是合并症和严重临床阶段的患者。此外，应加强针对老年人和吸烟者的预防计划，以在 COVID-19 后遭受器官衰竭之前挽救这部分人群。
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