Blanco-Taboada A L, Fernández-Ojeda M R, Castillo-Matus M M, Galán-Azcona M D, Salinas-Gutiérrez J, Ruiz-Romero M V
Unidad de Medicina Interna. Servicio de Medicina. Hospital San Juan de Dios del Aljarafe. Bormujos. Sevilla. España..
Unidad de Calidad e Investigación. Hospital San Juan de Dios del Aljarafe. Bormujos. Sevilla. España..
An Sist Sanit Navar. 2022 Jul 1;45(2):e1000. doi: 10.23938/ASSN.1000.
The clinical spectrum of COVID-19 varies from no or mild symptoms to pneumonia with fatal complications. The aim of the study was to find predictors of mortality and admission in the intensive care unit (ICU) in patients hospitalized for COVID-19.
Retrospective study of a cohort of patients admitted for COVID-19 between March 2020 and February 2021. Demographic, clinical, radiological and laboratory variables were described at admission. Independent predictors of mortality and ICU admission were identified by means of backward stepwise logistic regression and described in terms of odds ratio (OR) and 95% confidence interval (95%CI).
A total of 883 patients were included, 51.8% men with a mean age of 68; 1.8% readmissions. 17.6% of patients died (n=154). The independent predictors of mortality were age (OR=1.071; 95%CI: 1.046-1.095), percentage of oxygen saturation (SatO2) (OR=0.938; 95%CI: 0.903-0.974), diastolic blood pressure (DBP, OR= 0.972; 95%CI: 0.955-0.989), creatinine (OR=1.516; 95%CI: 1.088-2.113), INR (OR=1.199; 95%CI: 1.012-1.419) and sodium (OR=1.082; 95%CI: 1.037-1.128). Eight percent of patients were admitted to ICU; the independent predictors were: male sex (OR=2.079; 95%CI: 1.099-3.935), age (OR=0.960; 95%CI: 0.942-0.979), SatO2 (OR=0.925; 95%CI: 0.889-0.962), creatinine (OR=1.551; 95%CI: 1.118-2.152) and C-reactive protein (CRP, OR=1.003; 95%CI: 1.000-1.007).
The identification of independent predictors of mortality (age, SatO2, DBP, creatinine, INR, sodium) and ICU admission (sex, age, SatO2, creatinine, and CRP) allowed for the stratification of patients to adapt clinical care protocols to these findings, thereby improving medical decisions.
新型冠状病毒肺炎（COVID-19）的临床症状范围从无症状或轻微症状到伴有致命并发症的肺炎。本研究的目的是找出因COVID-19住院患者的死亡率及入住重症监护病房（ICU）的预测因素。
对2020年3月至2021年2月期间因COVID-19入院的一组患者进行回顾性研究。入院时描述人口统计学、临床、放射学和实验室变量。通过向后逐步逻辑回归确定死亡率和入住ICU的独立预测因素，并用比值比（OR）和95%置信区间（95%CI）进行描述。
共纳入883例患者，男性占51.8%，平均年龄68岁；再次入院率为1.8%。17.6%的患者死亡（n = 154）。死亡率的独立预测因素为年龄（OR = 1.071；95%CI：1.046 - 1.095）、血氧饱和度（SatO2）百分比（OR = 0.938；95%CI：0.903 - 0.974）、舒张压（DBP，OR = 0.972；95%CI：0.955 - 0.989）、肌酐（OR = 1.516；95%CI：1.088 - 2.113）、国际标准化比值（INR，OR = 1.199；95%CI：1.012 - 1.419）和钠（OR = 1.082；95%CI：1.037 - 1.128）。8%的患者入住ICU；独立预测因素为：男性（OR = 2.079；95%CI：1.099 - 3.935）、年龄（OR = 0.960；95%CI：0.942 - 0.979）、SatO2（OR = 0.925；95%CI：0.889 - 0.962）、肌酐（OR = 1.551；95%CI：1.118 - 2.152）和C反应蛋白（CRP，OR = 1.003；95%CI：1.000 - 1.007）。
确定死亡率（年龄、SatO2、DBP、肌酐、INR、钠）和入住ICU（性别、年龄、SatO2、肌酐和CRP）的独立预测因素有助于对患者进行分层，使临床护理方案适应这些结果，从而改善医疗决策。
