评估Charlson合并症指数和实验室参数作为新冠病毒19患者早期死亡率的独立预测指标
Evaluation of the Charlson Comorbidity Index and Laboratory Parameters as Independent Early Mortality Predictors in Covid 19 Patients.
作者信息
Cavuşoğlu Türker Betül, Türker Fatih, Ahbab Süleyman, Hoca Emre, Urvasızoğlu Ayşe Oznur, Cetin Seher Irem, Ataoğlu Hayriye Esra
机构信息
University of Health Sciences, Taksim Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey.
University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey.
出版信息
Int J Gen Med. 2022 Jul 27;15:6301-6307. doi: 10.2147/IJGM.S374246. eCollection 2022.
PURPOSE
Various parameters have been proposed to predict the outcome of patients with coronavirus disease. The aim of this study was to evaluate the utility of the age-adjusted CCI score and biochemical parameters for predicting outcomes for COVID-19 patients on admission.
PATIENTS AND METHODS
A total of 511 patients were included in the study. Only swab or serological tests positive patients were included. The clinical characteristics of the patients were compared between survival and non-survival COVID-19 inpatients. Hemoglobin, platelet, sedimentation, creatinine, AST, ALT, LDH, CK, albumin, ferritin, lymphocyte, neutrophil, CRP (1-5;5-10;10-20 × upper limit), procalcitonin (5-10;10-20; > 20 × upper limit), D Dimer (> 2 × upper limit), age, gender, chronic diseases and CCI scores were compared between the two groups.
RESULTS
68 patients died and 443 patients survived. Mean age was 74.3±7.3 years in survival group and 76.7±8.0 in nonsurvival group. Age, male sex, ischemic heart disease (CHD), chronic kidney disease and active malignancy was statistically higher in non-survivor group. The biochemical parameters was compared in survival and nonsurvival group. CCI score, AST, LDH, CK, Ferritin, CRP are significantly higher and albumin, lymphocyte levels are significantly lower in nonsurvival group. D-dimer and procalcitonin levels are significantly higher in nonsurvival group. CCI score and neutrophil, creatinine, ALT, AST, d-dimer and procalcitonin elevations were correlated. Low albumin and lymphocyte levels were correlated with the CCI score. There was no significant correlation between ferritin, sedimentation, CRP levels and CCI score. A multivariate logistic regression analysis indicated that anaemia, elevated CRP (> 10-20 × upper limit), procalcitonin (> 5-10 × upper limit), ALT, AST levels and higher CCI score were independent risk factors for mortality in COVID-19 patients.
CONCLUSION
Anaemia, elevated CRP, procalcitonin levels, ALT, AST levels and higher CCI score were found independent risk factors for mortality in COVID-19 patients.
目的
已提出多种参数来预测冠状病毒病患者的预后。本研究的目的是评估年龄校正后的CCI评分和生化参数对预测COVID-19患者入院时预后的效用。
患者与方法
本研究共纳入511例患者。仅纳入拭子或血清学检测呈阳性的患者。比较了COVID-19存活和非存活住院患者的临床特征。比较了两组患者的血红蛋白、血小板、血沉、肌酐、谷草转氨酶（AST）、谷丙转氨酶（ALT）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、白蛋白、铁蛋白、淋巴细胞、中性粒细胞、C反应蛋白（1 - 5；5 - 10；10 - 20×上限）、降钙素原（5 - 10；10 - 20；> 20×上限）、D - 二聚体（> 2×上限）、年龄、性别、慢性病和CCI评分。
结果
68例患者死亡，443例患者存活。存活组的平均年龄为74.3±7.3岁，非存活组为76.7±8.0岁。非存活组的年龄、男性、缺血性心脏病（CHD）、慢性肾病和活动性恶性肿瘤在统计学上更高。比较了存活组和非存活组的生化参数。非存活组的CCI评分、AST、LDH、CK、铁蛋白、C反应蛋白显著更高，白蛋白、淋巴细胞水平显著更低。非存活组的D - 二聚体和降钙素原水平显著更高。CCI评分与中性粒细胞、肌酐、ALT、AST、D - 二聚体和降钙素原升高相关。低白蛋白和淋巴细胞水平与CCI评分相关。铁蛋白、血沉、C反应蛋白水平与CCI评分之间无显著相关性。多因素逻辑回归分析表明，贫血、C反应蛋白升高（> 10 - 20×上限）、降钙素原升高（> 5 - 10×上限）、ALT、AST水平以及较高的CCI评分是COVID-19患者死亡的独立危险因素。
结论
贫血、C反应蛋白升高、降钙素原水平、ALT、AST水平以及较高的CCI评分是COVID-19患者死亡的独立危险因素。
Zotero 插件