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孟加拉国新冠肺炎住院老年患者的临床特征及死亡预测因素:一项多中心回顾性研究

Clinical Characteristics and Predictors of Mortality in Elderly Patients Hospitalized with COVID-19 in Bangladesh: A Multicenter, Retrospective Study.

作者信息

Asaduzzaman Md, Nazmul Alam Z H M, Zabed Jillul Bari Mohammad, Jahangir Alam M M, Ranjan Chakraborty Shishir, Ferdousi Tasnim

机构信息

Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet 3100, Bangladesh.

Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh.

出版信息

Interdiscip Perspect Infect Dis. 2022 Jun 11;2022:5904332. doi: 10.1155/2022/5904332. eCollection 2022.

Abstract

PURPOSE

Elderly patients are at high risk of fatality from COVID-19. The present work aims to describe the clinical characteristics of elderly inpatients with COVID-19 and identify the predictors of in-hospital mortality at admission.

MATERIALS AND METHODS

In this retrospective, multicenter cohort study, we included elderly COVID-19 inpatients ( = 245) from four hospitals in Sylhet, Bangladesh, who had been discharged between October 2020 and February 2021. Demographic, clinical, and laboratory data were extracted from hospital records and compared between survivors and nonsurvivors. We used univariable and multivariable logistic regression analysis to explore the risk factors associated with in-hospital death. . Of the included patients, 202 (82.44%) were discharged and 43 (17.55%) died in hospital. Except hypertension, other comorbidities like diabetes, chronic kidney disease, ischemic heart disease, and chronic obstructive pulmonary disease were more prevalent in nonsurvivors. Nonsurvivors had a higher prevalence of leukocytosis (51.2 versus 30.7; =0.01), lymphopenia (72.1 versus 55; =0.05), and thrombocytopenia (20.9 versus 9.9; =0.07). Multivariable regression analysis showed an increasing odds ratio of in-hospital death associated with older age (odds ratio 1.05, 95% CI 1.01-1.10, per year increase; =0.009), thrombocytopenia (OR = 3.56; 95% CI 1.22-10.33, =0.019), and admission SpO (OR 0.91, 95% CI 0.88-0.95; =0.001).

CONCLUSIONS

Higher age, thrombocytopenia, and lower initial level of SpO at admission are predictors of in-hospital mortality in elderly patients with COVID-19.

摘要

目的

老年患者因新型冠状病毒肺炎(COVID-19)死亡的风险很高。本研究旨在描述老年COVID-19住院患者的临床特征,并确定入院时院内死亡的预测因素。

材料与方法

在这项回顾性多中心队列研究中,我们纳入了2020年10月至2021年2月期间在孟加拉国锡尔赫特的四家医院出院的245例老年COVID-19住院患者。从医院记录中提取人口统计学、临床和实验室数据,并在幸存者和非幸存者之间进行比较。我们使用单变量和多变量逻辑回归分析来探讨与院内死亡相关的危险因素。纳入的患者中,202例(82.44%)出院,43例(17.55%)在医院死亡。除高血压外,糖尿病、慢性肾脏病、缺血性心脏病和慢性阻塞性肺疾病等其他合并症在非幸存者中更为普遍。非幸存者白细胞增多症(51.2对30.7;P=0.01)、淋巴细胞减少症(72.1对55;P=0.05)和血小板减少症(20.9对9.9;P=0.07)的患病率更高。多变量回归分析显示,与年龄较大(比值比1.05,95%可信区间1.01-1.10,每年增加;P=0.009)、血小板减少症(OR=3.56;95%可信区间1.22-10.33,P=0.019)和入院时SpO₂(OR 0.91,95%可信区间0.88-0.95;P=0.001)相关的院内死亡比值比增加。

结论

年龄较大、血小板减少症以及入院时较低的初始SpO₂水平是老年COVID-19患者院内死亡的预测因素。

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