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在埃塞俄比亚西部沃尔加大学转诊医院治疗中心住院的 COVID-19 患者死亡的发生率和预测因素:一项回顾性队列研究。

Incidence and predictors of death from COVID-19 among patients admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia: A retrospective cohort study.

机构信息

Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

出版信息

PLoS One. 2022 Jul 27;17(7):e0267827. doi: 10.1371/journal.pone.0267827. eCollection 2022.

Abstract

INTRODUCTION

Currently, COVID-19 contributes to mortality and morbidity in developed as well as in developing countries since December 2019. However, there is scarcity of evidence regarding the incidence and predictors of death among patients admitted with COVID-19 in developing country including Ethiopia, where the numbers of deaths are under-reported. Hence, this study aimed to assess the incidence and predictors of death among patients admitted with COVID-19 in Wollega University Referral Hospital (WURH), western Ethiopia.

METHODS

An institution based retrospective cohort study design was conducted among 318 patients admitted with COVID-19 in WURH treatment center. Patients who were tested positive for COVID-19 by using rRT-PCR test and admitted with the diagnosis of severe COVID-19 cases from September 30, 2020 to June 10, 2021 were a source population. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with mortality from COVID-19. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of mortality from COVID-19 at p-value < 0.05.

RESULTS

A total of 318 patients were included in final analysis with mean age of 44 (SD±16.7) years and about two third (67.9%) were males. More than half (55.7%) of patients had no comorbidity on admission. The majority, 259 (81.45%) of patients recovered from COVID-19 and 267 (84%) of patients were censored at the end of follow up. The incidence rate of mortality was 14.1 per/1000 (95%CI: 10.7, 18.5) person days observation. Age ≥ 59 years (AHR: 5.76, 95%CI: 2.58, 12.84), low oxygen saturation (AHR: 2.34, 95% CI: (2.34, 4.17), and delayed presentation (AHR: 5.60, 95%CI: 2.97, 10.56) were independent predictors of mortality among COVID-19 patients.

CONCLUSION

The mortality rate of COVID-19 pandemic was high in the study area, and most of death was happened during the first 10 days. Being old age, low oxygen saturation and delayed presentation were factors which predict mortality due to COVID-19. Hence, strengthening the health care delivery system to satisfy the need of the patients should get due attention to reduce the incidence of mortality from COVID-19 cases.

摘要

简介

自 2019 年 12 月以来,COVID-19 导致发达国家和发展中国家的死亡率和发病率上升。然而,在包括埃塞俄比亚在内的发展中国家,有关 COVID-19 患者入院后死亡的发生率和预测因素的证据稀缺,这些国家的死亡人数报告不足。因此,本研究旨在评估在埃塞俄比亚西部的沃勒加大学转诊医院(WURH)住院的 COVID-19 患者的死亡率和预测因素。

方法

这是一项在 WURH 治疗中心住院的 318 名 COVID-19 患者中进行的基于机构的回顾性队列研究设计。研究对象为 2020 年 9 月 30 日至 2021 年 6 月 10 日期间通过 rRT-PCR 检测呈 COVID-19 阳性且被诊断为严重 COVID-19 病例的患者。Epidata 版本 3.2 用于数据输入,STATA 版本 14 用于分析。使用 Cox 比例风险回归分析确定与 COVID-19 死亡率相关的因素。使用多变量 Cox 回归模型(95%CI 和调整后的风险比 [AHR]),以 p 值 < 0.05 确定 COVID-19 死亡率的显著预测因素。

结果

共有 318 名患者纳入最终分析,平均年龄为 44 岁(SD±16.7),约三分之二(67.9%)为男性。超过一半(55.7%)的患者入院时无合并症。大多数(81.45%)患者在 COVID-19 中康复,267 例(84%)患者在随访结束时被删失。死亡率为每 1000 人 14.1 人天(95%CI:10.7,18.5)。年龄≥59 岁(AHR:5.76,95%CI:2.58,12.84)、低氧饱和度(AHR:2.34,95%CI:2.34,4.17)和延迟就诊(AHR:5.60,95%CI:2.97,10.56)是 COVID-19 患者死亡的独立预测因素。

结论

研究地区 COVID-19 死亡率较高,大多数死亡发生在第 10 天之前。年龄较大、低氧饱和度和延迟就诊是 COVID-19 死亡的预测因素。因此,应加强医疗保健系统以满足患者的需求,以降低 COVID-19 病例的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e65c/9328505/e4a3c04eb86c/pone.0267827.g001.jpg

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