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住院 COVID-19 患者接受有创机械通气的预测因素:来自约旦的回顾性研究。

Predictors of invasive mechanical ventilation in hospitalized COVID-19 patients: a retrospective study from Jordan.

机构信息

Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Ontario, Canada.

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Expert Rev Respir Med. 2022 Aug;16(8):945-952. doi: 10.1080/17476348.2022.2108796. Epub 2022 Aug 8.

Abstract

OBJECTIVES

To identify early indicators for invasive mechanical ventilation utilization among COVID-19 patients.

METHODS

This retrospective study evaluated COVID-19 patients who were admitted to hospital from 20 September 2020, to 8 August 2021. Multivariable logistic regression and machine learning (ML) methods were employed to assess variable significance.

RESULTS

Among 1,613 confirmed COVID-19 patients, 365 patients (22.6%) received invasive mechanical ventilation (IMV). Factors associated with IMV included older age >65 years (OR,1.46; 95%CI, 1.13-1.89), current smoking status (OR, 1.71; 95%CI, 1.22-2.41), critical disease at admission (OR, 1.97; 95%CI, 1.28-3.03), and chronic kidney disease (OR, 2.07; 95%CI, 1.37-3.13). Laboratory abnormalities that were associated with increased risk for IMV included high leukocyte count (OR, 2.19; 95%CI, 1.68-2.87), low albumin (OR, 1.76; 95%CI, 1.33-2.34) and high AST (OR, 1.71; 95%CI, 1.31-2.22).

CONCLUSION

Our study suggests that there are several factors associated with the increased need for IMV among COVID-19 patients. These findings will help in early identification of patients at high risk for IMV and reallocation of hospital resources toward patients who need them the most to improve their outcomes.

摘要

目的

确定 COVID-19 患者中使用有创机械通气的早期指标。

方法

本回顾性研究评估了 2020 年 9 月 20 日至 2021 年 8 月 8 日期间住院的 COVID-19 患者。采用多变量逻辑回归和机器学习(ML)方法评估变量的重要性。

结果

在 1613 例确诊的 COVID-19 患者中,有 365 例(22.6%)接受了有创机械通气(IMV)。与 IMV 相关的因素包括年龄>65 岁(OR,1.46;95%CI,1.13-1.89)、当前吸烟状况(OR,1.71;95%CI,1.22-2.41)、入院时的危急疾病(OR,1.97;95%CI,1.28-3.03)和慢性肾脏病(OR,2.07;95%CI,1.37-3.13)。与 IMV 风险增加相关的实验室异常包括白细胞计数升高(OR,2.19;95%CI,1.68-2.87)、白蛋白降低(OR,1.76;95%CI,1.33-2.34)和 AST 升高(OR,1.71;95%CI,1.31-2.22)。

结论

本研究表明,COVID-19 患者中有多种因素与对 IMV 的需求增加相关。这些发现将有助于早期识别出需要 IMV 的高危患者,并将医院资源重新分配给最需要的患者,以改善他们的结局。

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